| Aeg Florida Professional Pllc | |
|
4788 Hodges Blvd Ste 205, Jacksonville, FL 32224-7223 | |
| (904) 992-9991 | |
| Not Available |
| Full Name | Aeg Florida Professional Pllc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 4788 Hodges Blvd Ste 205, Jacksonville, Florida |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164156246 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| Provider Name | Kelli Lee Parks |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1992791990 PECOS PAC ID: 8729983440 Enrollment ID: I20031204000983 |
| Provider Name | Carol Armstrong Logan |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1831260033 PECOS PAC ID: 7618964164 Enrollment ID: I20040427001630 |
| Provider Name | Vijayan Nair |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1740352343 PECOS PAC ID: 0244229169 Enrollment ID: I20040514000903 |
| Provider Name | Rima K Klimas |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1992876197 PECOS PAC ID: 4880647049 Enrollment ID: I20050228000675 |
| Provider Name | Robert K Smith |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1497738595 PECOS PAC ID: 2567402985 Enrollment ID: I20050505000224 |
| Provider Name | Scott M Pearl |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1467452474 PECOS PAC ID: 7618917303 Enrollment ID: I20050512000296 |
| Provider Name | Richard D Marrotte |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1184612780 PECOS PAC ID: 3678515624 Enrollment ID: I20050531000846 |
| Provider Name | Christopher P Martz |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1659384162 PECOS PAC ID: 4688608128 Enrollment ID: I20050924000046 |
| Provider Name | Ronald Kevin Quinn |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1508806068 PECOS PAC ID: 4082627823 Enrollment ID: I20060724000139 |
| Provider Name | Robert Orsillo |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1336209998 PECOS PAC ID: 3072596345 Enrollment ID: I20070806000687 |
| Provider Name | James A Horning |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1710063086 PECOS PAC ID: 8224113493 Enrollment ID: I20080312000215 |
| Provider Name | Kara Meg Bachus |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1174694376 PECOS PAC ID: 1254401078 Enrollment ID: I20080605000698 |
| Provider Name | Amber Aria |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1568610087 PECOS PAC ID: 1355409236 Enrollment ID: I20081021000759 |
| Provider Name | Steven M Shaw |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1881841492 PECOS PAC ID: 4880732692 Enrollment ID: I20091117000070 |
| Provider Name | Sandra D Joly |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1831282805 PECOS PAC ID: 8820138027 Enrollment ID: I20091219000105 |
| Provider Name | Nadia Lynne Strucko |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1912139759 PECOS PAC ID: 8729128509 Enrollment ID: I20091230000128 |
| Provider Name | Ben Larson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1316047079 PECOS PAC ID: 6204917180 Enrollment ID: I20101012001004 |
| Provider Name | Christy Larson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1821160201 PECOS PAC ID: 2668553538 Enrollment ID: I20101019001485 |
| Provider Name | Douglas R Tupps |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1124062989 PECOS PAC ID: 4082729306 Enrollment ID: I20101020001039 |
| Provider Name | Paul Thomas Fulghum |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1962436121 PECOS PAC ID: 5597958629 Enrollment ID: I20101025000735 |
| Provider Name | Neil Macali |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1992786172 PECOS PAC ID: 9234248170 Enrollment ID: I20101111000405 |
| Provider Name | Amy Butterfield Ward |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1962493734 PECOS PAC ID: 0446431233 Enrollment ID: I20110228000507 |
| Provider Name | Richard Greene |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1114039336 PECOS PAC ID: 9830377365 Enrollment ID: I20110701000187 |
| Provider Name | Michele Mclin |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1407103542 PECOS PAC ID: 0941459143 Enrollment ID: I20121003000562 |
| Provider Name | Sean G. Walton |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1720244387 PECOS PAC ID: 8325105943 Enrollment ID: I20140304001534 |
| Provider Name | Mari Shelly Holderby |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1881001626 PECOS PAC ID: 0143440065 Enrollment ID: I20140927000238 |
| Provider Name | Michelle E Cevallos |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1104070788 PECOS PAC ID: 3173783826 Enrollment ID: I20150209000605 |
| Provider Name | Sheryl Reaves |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1023301280 PECOS PAC ID: 7315194826 Enrollment ID: I20150213000305 |
| Provider Name | Natalia Noble |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1063827228 PECOS PAC ID: 0143440586 Enrollment ID: I20150825005598 |
| Provider Name | Stephanie D'orazio-brafman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1811372279 PECOS PAC ID: 6406156678 Enrollment ID: I20151120000823 |
| Provider Name | Catherine R Borgeson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1780065011 PECOS PAC ID: 1759675770 Enrollment ID: I20160812001733 |
| Provider Name | Candace Brown Suggs |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1376072280 PECOS PAC ID: 3274803374 Enrollment ID: I20170724000219 |
| Provider Name | Tammy Le |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1255693263 PECOS PAC ID: 7012163116 Enrollment ID: I20180215001841 |
| Provider Name | Christopher S Castello |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1184603284 PECOS PAC ID: 5193058378 Enrollment ID: I20190603000873 |
| Provider Name | Amy Ruzicka |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1508368556 PECOS PAC ID: 8022372887 Enrollment ID: I20200511001157 |
| Provider Name | Erin Mccabe |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1558524405 PECOS PAC ID: 1759440407 Enrollment ID: I20200521000592 |
| Provider Name | Kaitlin Jaquett Brown |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1154945814 PECOS PAC ID: 0042632820 Enrollment ID: I20200624001784 |
| Provider Name | Angelica Jones |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1104418490 PECOS PAC ID: 9234545583 Enrollment ID: I20210310002695 |
| Provider Name | Shruti Desai |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1588140636 PECOS PAC ID: 7810244555 Enrollment ID: I20210507000661 |
| Provider Name | Alberta Dagobert |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1982197687 PECOS PAC ID: 8123427325 Enrollment ID: I20210520000331 |
| Provider Name | Theresa Wang |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1881021186 PECOS PAC ID: 2163746397 Enrollment ID: I20210917002272 |
| Provider Name | Kenneth Parker |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1811588593 PECOS PAC ID: 6901296136 Enrollment ID: I20211202001791 |
| Provider Name | Todd Smith |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1831202076 PECOS PAC ID: 5597785790 Enrollment ID: I20211208001478 |
| Provider Name | Jordan Claboine |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1336706985 PECOS PAC ID: 4789071473 Enrollment ID: I20220427002699 |
| Provider Name | Sierra Marie Mattox |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1003546912 PECOS PAC ID: 9931580131 Enrollment ID: I20220719003458 |
| Provider Name | Tania Malara |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1003966839 PECOS PAC ID: 6507965589 Enrollment ID: I20221010000885 |
| Mailing Address | Practice Location Address |
|---|---|
| Aeg Florida Professional Pllc 111 E 4th St Ste 440, Alton, IL 62002-6241 Ph: (618) 462-9818 | Aeg Florida Professional Pllc 4788 Hodges Blvd Ste 205, Jacksonville, FL 32224-7223 Ph: (904) 992-9991 |
Northeast Florida Eye Care Addociates Optometrist Medicare: Not Enrolled in Medicare Practice Location: 4413 Town Center Pkwy, Suite 207, Jacksonville, FL 32246 Phone: 904-998-9822 | |
Dr. Sierra Marie Mattox, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 4788 Hodges Blvd, Jacksonville, FL 32224 Phone: 904-992-9991 | |
Dr. Sheila D Merritt, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 9760 San Jose Blvd, Jacksonville, FL 32257 Phone: 904-268-2299 | |
Melanie J Carvell, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 5921 Collins Rd, Suite 1, Jacksonville, FL 32244 Phone: 904-777-3937 Fax: 904-777-8208 | |
Danielle Callegari, Optometrist Medicare: Accepting Medicare Assignments Practice Location: 9041 Southside Blvd, Jacksonville, FL 32256 Phone: 904-519-5057 | |
Steven H Schwartz, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 3 Shircliff Way, Ste 122, Jacksonville, FL 32204 Phone: 904-388-3109 Fax: 904-388-9132 | |
Dr. Hewell Eaves, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 7205 Bonneval Rd, Jacksonville, FL 32256 Phone: 904-296-0098 |