SPECIALTY RETINA CENTER LLC
NPI 1689807232
Ophthalmology in Deerfield Beach, FL

Q: What is Specialty Retina Center LLC's NPI number?

The NPI number for Specialty Retina Center LLC is 1689807232. It was assigned to this organization in the NPPES registry on August 31, 2009.

Q: What is Specialty Retina Center LLC's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Active since August 31, 2009CLIA 10D2107599 · Waiver

2001 W SAMPLE RD STE 320, DEERFIELD BEACH, FL 33064(561) 322-3588(754) 812-5993 Get Directions Write a Review

NPPES record last updated: February 5, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Specialty Retina Center Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SPECIALTY RETINA CENTER LLC (NPI 1689807232) is a healthcare organization registered as an ophthalmology in Deerfield Beach, Florida and active in the NPI registry since August 2009. The organization holds a CLIA Waiver certificate valid through January 18, 2028, maintains a secondary practice location in Boca Raton, and lists Shatina M Cannon, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1689807232

Entity TypeOrganization

Primary Taxonomy207W00000X

Legal Business NameSPECIALTY RETINA CENTER LLC

Location Address2001 W SAMPLE RD STE 320Deerfield Beach, FL 33064-1342

Mailing Address2001 W Sample Rd Ste 320Deerfield Beach, FL 33064-1342 · (561) 322-3588 · Fax (754) 812-5993

Phone(561) 322-3588

Fax(754) 812-5993

Organization SubpartNo

Authorized OfficialShatina M CannonOffice Manager · (561) 322-3588

Enumeration DateAugust 31, 2009

Last NPPES UpdateFebruary 5, 2025

NPPES CertifiedFebruary 5, 2025

✔ NPI 1689807232 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians

Taxonomy Code207W00000X

License✔ Licensed in FL · ME 81086

Definition

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.

2001 W SAMPLE RD STE 320, Deerfield Beach, FL 33064

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Secondary Practice Location 1

Location 121301 Powerline Rd Ste 105Boca Raton, FL 33433-2389 · Phone (561) 322-3588 · Fax (754) 812-5993

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Specialty Retina Center Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 10 clinicians reassign Medicare billing to Specialty Retina Center LLC, which bills Medicare for the services they deliver. Of these, 5 practice at this address. They are listed nearest first.