William a Olivos OD PA

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

WILLIAM A OLIVOS OD PA

Practice address

2710 SW Port St Lucie Blvd
Port Saint Lucie, FL 34953-2849

Phone

(772) 460-8487

Fax

(772) 460-0225

NPI assigned

Jul 22, 2021

Organization subpart

No

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

Authorized official

Name

Dr. William A Olivos, ODNPI 1326017658

Title

Owner

Phone

(772) 460-8487

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Advanced Eye Care Center Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William A Olivos, OD

  • Optometrist
  • Fort Pierce, FL
  • NPI 1326017658
  NPD Authorized official

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

{
    "created_epoch": "1626912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626998400000",
    "number": "1962075358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 SW PORT ST LUCIE BLVD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349532849",
            "telephone_number": "772-460-8487",
            "fax_number": "772-460-0225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 SW PORT ST LUCIE BLVD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349532849",
            "telephone_number": "772-460-8487",
            "fax_number": "772-460-0225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM A OLIVOS OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-22",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A",
        "authorized_official_last_name": "OLIVOS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-460-8487",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002946001",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Eye Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joseph Michael Wierzbicki, MD
• Jennifer L Wild, OTR
• Amy L Wilder, HAS, BC-HIS
• Nell Wilkins
• Margaret Wilkinson-Cox
• William P.J. Yetman Crna, PA
• Claudia Shalini William, MD
• Bria Williams
• Cayuna Lashai Williams
• Celina Williams

• Optometrist in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.