SUZETTE ANN BLAHNIK (NPI# 1619927118) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619927118 |
| Entity Type | Individual |
| Full Name | SUZETTE ANN BLAHNIK |
| Credential | O.D. |
| Practice Address |
3740 S Ridgewood Ave Unit 103 Port Orange FL 32129-3519 |
| Practice Telephone | 3864926999 |
| Practice Fax Number | 3864926900 |
| Mailing Telephone | 3864926999 |
| Mailing Fax Number | 3864926900 |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2009-06-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | OPC2506 | FL | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | OPTOMETRIST LICENSE | OPC2506 | 01 |
| FL | 078846500 | 05 |
| Street Address |
3740 S RIDGEWOOD AVE UNIT 103 |
| City | PORT ORANGE |
| State | FL |
| Zip Code | 32129-3519 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851475172 | Donald Glenn Purcell | Optometrist | 3740 S Ridgewood Ave Unit 103, Port Orange, FL 32129-3519 | 2006-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982179818 | Port Orange Modern Dentistry, Pa | Dentist | 1765 Dunlawton Ave., Suite 103, Port Orange, FL 32129 | 2018-10-08 |
| 1932698131 | Brittany Michele Claude | Behavioral Analyst | 4647 Clyde Morris Blvd Suite 501, Port Orange, FL 32129 | 2018-05-03 |
| 1760919468 | Makayla Earl | Behavior Technician | 1557 Town Park Dr., Port Orange, FL 32129 | 2017-05-12 |
| 1184157968 | Katie Lynn Weisz | Physician Assistant | 3635 South Clyde Morris Blvd, Suite 100, Port Orage, FL 32129 | 2017-04-07 |
| 1285178319 | Mallory Driggers | Counselor | 980 Canal View Blvd Apt F7, Port Orange, FL 32129 | 2016-12-08 |
| 1912321654 | Edward L. Staudt Dds & Kenneth L. Staudt Dds, Mph | Dentist | 944 Bridgewater Dr., Suite 2-b, Port Orange, FL 32129 | 2014-02-18 |
| 1538411731 | Roberta Ann Gilmartin | Specialist | 1048 W Samms Ave, Port Orange, FL 32129 | 2012-10-11 |
| 1679892996 | Pamela Kirby Pa | Clinic/Center | 4606 South Clyde Morris Boulevard, Suite 1j, Port Orange, FL 32129 | 2010-05-26 |
| 1326376385 | Connie Jeanne Bodnarik | Physical Therapy Assistant | 3780 S Clyde Morris Blvd Apt 1206, Port Orange, FL 32129 | 2009-12-02 |
| 1669645057 | American Family & Sports Chiropractic Center Inc | Chiropractor | 4649 Clyde Morris Blvd Unit 609, Port Orange, FL 32129 | 2008-04-08 |
| Find all providers in zip 32129 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639489883 | Dr. Michael Hay and Associates, LLC | Optometrist | 5517 S. Williamson Blvd., #310, Port Orange, FL 32128 | 2010-10-20 |
| 1043462914 | Blahnik Eye Care Inc | Optometrist | 3740 S Ridgewood Ave, Unit 103, Port Orange, FL 32129-3510 | 2008-10-22 |
| 1891958963 | Broome Vision Inc. | Optometrist | 3781o S Nova Rd Ste O, Port Orange, FL 32129-4233 | 2008-07-08 |
| 1598984676 | Total Vision of Port Orange, Inc. | Optometrist | 5820 S Williamson Blvd Ste 106, Port Orange, FL 32128-6400 | 2007-04-25 |
| 1912097353 | Daytona Vision Center Inc | Optometrist | 733 Dunlawton Avenue, Suite 101, Port Orange, FL 32127 | 2006-10-14 |
| 1982631792 | Frank Anthony Broome Jr. | Optometrist | 3781 S Nova Rd Ste O, Port Orange, FL 32129-4285 | 2006-06-27 |
| 1265488134 | Gregory T Kipp | Optometrist | 3820 S Nova Rd, Port Orange, FL 32127-4949 | 2006-05-25 |
| 1265424188 | Kirsten Reed Wilgers | Optometrist | 5820 Williamson Blvd, Suite 106, Port Orange, FL 32128-6100 | 2005-08-17 |
| 1992258461 | Robert Cyrus Phyfer | Optometrist | 1771 Dunlawton Ave, Port Orange, FL 32127-4757 | 2016-08-01 |
| 1295126167 | Elizabeth Josephine Lee | Optometrist | 1771 Dunlawton Ave, Port Orange, FL 32127-4757 | 2015-02-12 |
| Find all providers in PORT ORANGE | ||||
| City | PORT ORANGE |
| Zip Code | 32129 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.