Optica Latina, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT002681 Issued in GA

Legal business name

OPTICA LATINA, LLC

Practice address

4485 Lawrenceville Hwy NW
Suite 206
Lilburn, GA 30047-3669

Phone

(770) 674-1712

Fax

(770) 687-2921

NPI assigned

Jan 10, 2013

Organization subpart

No

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

Authorized official

Name

Leonel E Coello, LDO

Title

Owner

Phone

(770) 815-1915

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

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

• Mary R Coello, O.D.

  • Optometrist
  • Atlanta, GA
  • NPI 1679845739
  Medicare reassignment

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

{
    "created_epoch": "1357776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357776000000",
    "number": "1992042972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4485 LAWRENCEVILLE HWY NW",
            "address_2": "SUITE 206",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473669",
            "telephone_number": "770-674-1712",
            "fax_number": "770-687-2921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4485 LAWRENCEVILLE HWY NW",
            "address_2": "SUITE 206",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473669",
            "telephone_number": "770-674-1712",
            "fax_number": "770-687-2921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTICA LATINA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-10",
        "last_updated": "2013-01-10",
        "status": "A",
        "authorized_official_last_name": "COELLO",
        "authorized_official_first_name": "LEONEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-815-1915",
        "authorized_official_credential": "LDO"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002681",
            "primary": true
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "GA",
            "license": "LDO001948",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hanifa Akpe Okoli, LPC
• Jesika Olguin
• Omnipresence Care Management
• Babatunde Ibikunle Onasanya, MD
• Belinda I Opara, NURSE PRACTITIONER
• Optimum Health Management Corporation
• Optimus Hospitality
• Tanyetta Nicole Osborne
• Abosede A Oshinubi, RD, LD
• Outreach Pharmacy LLC

• Optometrist in Lilburn, GA
• Providers in Lilburn, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2013; 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.