DR. SRINI MUTYALA (NPI# 1689654717) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689654717 |
| Entity Type | Individual |
| Full Name | DR. SRINI MUTYALA |
| Credential | M.D. |
| Practice Address |
2625 Executive Park Dr Suite #4 Weston FL 33331-3634 |
| Practice Telephone | 9546599051 |
| Practice Fax Number | 9546599052 |
| Mailing Telephone | 9546599051 |
| Mailing Fax Number | 9546599052 |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2008-03-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | ME0076746 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 254938700 | 05 |
| Street Address |
2625 EXECUTIVE PARK DR SUITE #4 |
| City | WESTON |
| State | FL |
| Zip Code | 33331-3634 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013247949 | Garfield A Munroe | Ophthalmology | 2625 Executive Park Dr, Suite#4, Weston, FL 33331-3634 | 2009-12-24 |
| 1205068657 | Mary Catherine Cunningham-portner | Occupational Therapist | 2625 Executive Park Dr, Suite 3, Weston, FL 33331-3634 | 2009-08-19 |
| 1871728261 | Lorena Y Lechter | Specialist | 2625 Executive Park Dr, Weston, FL 33331-3634 | 2009-05-28 |
| 1689812521 | Joann Harris Gorn | Social Worker | 2625 Executive Park Dr, Suite 3, Weston, FL 33331-3634 | 2009-01-30 |
| 1568642676 | Weston Laser & Vision Institute, Inc | Ophthalmology | 2625 Executive Park Dr, Suite 4, Weston, FL 33331-3634 | 2007-11-06 |
| 1508063637 | Biscayne Diagnostic Imaging | Radiology | 2625 Executive Park Dr, Suite 1, Weston, FL 33331-3634 | 2007-07-02 |
| 1841321775 | Nhat M. Le | Dentist | 2625 Executive Park Dr, Suite 8, Weston, FL 33331-3634 | 2007-03-09 |
| 1558492363 | Guillermo Pedro Rodriguez | Dentist | 2625 Executive Park Dr, Suite 2, Weston, FL 33331-3634 | 2007-03-07 |
| 1235269671 | Health Imaging Network LLC | Radiology | 2625 Executive Park Dr, Suite One, Weston, FL 33331-3634 | 2007-03-06 |
| 1477653285 | Azita Moosavi | Dentist | 2625 Executive Park Dr, Suite #2, Weston, FL 33331-3634 | 2006-09-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427679836 | Health Diagnostics of Fort Lauderdale, LLC | Radiology | 16604 Sheridan Street, Pembroke Pines, FL 33331 | 2020-04-27 |
| 1689212854 | Rumman Ahmed Khalid | Student in an Organized Health Care Education/Training Program | 16129 Opal Creek Drive, Weston, FL 33331 | 2019-12-18 |
| 1275015505 | B & B Monitoring LLC | Emergency Response System Companies | 4474 Weston Road, Suite 3, Ft Lauderdale, FL 33331 | 2018-09-04 |
| 1609367747 | Gerardo Minsal, Md Pa | Internal Medicine | 16720 Sapphire Springs, Weston, FL 33331 | 2018-05-24 |
| 1447747258 | Mario Ricardo Pimentel | Student in an Organized Health Care Education/Training Program | 2950 Cleveland Clinic Boulevard, Weston, FL 33331 | 2018-04-17 |
| 1619471547 | Farida Makubelly Law | Nurse Practitioner | 3100 Cleveland Clinic, Weston, FL 33331 | 2018-03-23 |
| 1942709902 | John Kross Pharmacy #2, Inc | Pharmacy | 16618 Sheridan St, Fort Lauderdale, FL 33331 | 2018-02-06 |
| 1922512342 | Luisa Fernanda Quevedo | Occupational Therapy Assistant | 4350 Mahogany Ridge Dr, Weston, FL 33331 | 2017-11-21 |
| 1144752551 | Therese Youssef Andraos | Student in an Organized Health Care Education/Training Program | 2950 Cleveland Clinic Blvd., Weston, FL 33331 | 2017-04-03 |
| 1255720843 | Horse and Petting Pal Interaction, Inc. | Counselor | 17800 Sw 52 Ct, Southwest Ranches, FL 33331 | 2015-01-20 |
| Find all providers in zip 33331 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003446444 | Regional Eye Associates, Inc | Ophthalmology | 402 Medical Park Dr Ste 100, Weston, WV 26452-1678 | 2020-01-24 |
| 1003187568 | Vision Unlimited Eye Consultants Pa | Ophthalmology | 1608 Town Center Cir, Suite C, Weston, FL 33326-3639 | 2012-01-15 |
| 1295976512 | George P Santos | Ophthalmology | 4 Stillmeadow Rd, Weston, MA 02493-1932 | 2009-03-17 |
| 1235276577 | John G Sebestyen | Ophthalmology | 17 Dickson Ln, Weston, MA 02493-2635 | 2007-01-30 |
| 1356360952 | James Andrew Fleischman | Ophthalmology | 2507 Eagle Watch Ln, Weston, FL 33327-1405 | 2006-07-18 |
| 1013951839 | Marc E Bosem | Ophthalmology | 2300 N Commerce Parkway, Suite 201, Weston, FL 33326-3255 | 2006-06-15 |
| 1194790832 | Richard Paul Floyd | Ophthalmology | 23 Pinecroft Rd, Weston, MA 02493-1772 | 2006-02-17 |
| 1013247949 | Garfield A Munroe | Ophthalmology | 2625 Executive Park Dr, Suite#4, Weston, FL 33331-3634 | 2009-12-24 |
| 1487884698 | Rop Consultants of South Florida | Ophthalmology | 2300 N Commerce Pkwy, Suite 307, Weston, FL 33326-3254 | 2009-07-22 |
| 1932364494 | Barry M Concool Md LLC | Ophthalmology | 2300 N Commerce Pkwy, Suite 201, Weston, FL 33326-3254 | 2008-07-24 |
| Find all providers in WESTON | ||||
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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.