Full Spectrum Family Vision Care PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC3636 Issued in FL

Legal business name

FULL SPECTRUM FAMILY VISION CARE PA

Practice address

217 Del Prado Blvd S Ste 101
Cape Coral, FL 33990-1743

Phone

(239) 573-3937

Fax

(239) 573-0263

NPI assigned

Apr 9, 2008

Last updated

May 26, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Heather L Trapheagen, OD

Title

Owner/President

Phone

(239) 573-3937

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Tax ID family

Full Spectrum Family Vision Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Full Spectrum Family Vision Care PA

  • Durable Medical Equipment & Medical Supplies
  • Cape Coral, FL
  • NPI 1295900728
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joanna Madonna Kluesner, OD

  • Optometrist
  • Port Charlotte, FL
  • NPI 1952909855
  Medicare reassignment NPD
• Heather L Morales, OD

  • Optometrist
  • Cape Coral, FL
  • NPI 1992796783
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590451200000",
    "number": "1932372158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 DEL PRADO BLVD S STE 101",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339901743",
            "telephone_number": "239-573-3937",
            "fax_number": "239-573-0263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 DEL PRADO BLVD S STE 101",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339901743",
            "telephone_number": "239-573-3937",
            "fax_number": "239-573-0263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL SPECTRUM FAMILY VISION CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-09",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A",
        "authorized_official_last_name": "TRAPHEAGEN",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "239-573-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3636",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": "OPC3636",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Fulbright, RPH
• Julie Marie Fulkerson, LMT
• Full Circle of Love LLC
• Full Circle of Love LLC
• Full Spectrum Family Vision Care PA
• Full Spectrum Medical Solutions LLC
• Sabrina Ranee Lacalle Fullen, DC
• Donn O Fuller, MD
• Madisen Fuller, LCSW
• Jayme Fusco

• Optometrist in Cape Coral, FL
• Providers in Cape Coral, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.