Organization Active NPI

1162 Military Trail LLC

Doing business as The Eye Gallery-Miami

  • Ophthalmology Physician
  • Miami, FL
National Provider Identifier
1962748244
Registry record updated Dec 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
1162 MILITARY TRAIL LLC
Doing business as
The Eye Gallery-Miami
Practice address
1661 SW 37TH Ave
#102
Miami, FL 33145-1754
Phone
(305) 774-0891
Fax
(305) 774-0894
NPI assigned
Dec 14, 2012
Last updated
Dec 14, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2012

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

Authorized official

Name
Erica Perreira
Title
Chief Operating Officer
Phone
(877) 881-0022

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X FL
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X FL Primary

Addresses

Primary practice location

1661 SW 37TH Ave
#102
Miami, FL 33145-1754

Mailing address

8076 W Sahara Ave
Las Vegas, NV 89117-7930
Phone (877) 881-0022

Other names 1

  • The Eye Gallery-Miami Doing business as

National Provider Directory

National Provider Directory
Tax ID family
1162 Military Trail LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1355443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355443200000",
    "number": "1962748244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8076 W SAHARA AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891177930",
            "telephone_number": "877-881-0022",
            "fax_number": "702-543-0314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1661 SW 37TH AVE",
            "address_2": "#102",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331451754",
            "telephone_number": "305-774-0891",
            "fax_number": "305-774-0894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1162 MILITARY TRAIL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-14",
        "last_updated": "2012-12-14",
        "status": "A",
        "authorized_official_last_name": "PERREIRA",
        "authorized_official_first_name": "ERICA",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "877-881-0022"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Eye Gallery-Miami",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2012; 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.