Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Justin Blaine Waller, OD

Individual provider Optometrist · NPI 1780239640

Dr. Justin Blaine Waller, OD is an Optometry in Orlando, Florida. Qualified in 2019, 7 years ago. Accepts Medicare assignment. Licensed in Florida.

Years since qualifying
7
Licensed in
FL
In the registry since
2019
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

2830 N Hiawassee Rd
Orlando, FL 32818-3319
Phone: (863) 529-3119
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence OPC5725 (FL)

Record details

NPI number1780239640
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorNo
NPI enumeratedAugust 7, 2019
Last updated in NPPESAugust 25, 2025
Certification dateAugust 25, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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