| |
13529 Beach Blvd # 102, Jacksonville, FL 32224-0288 | |
(904) 256-9344 | |
(561) 828-8367 |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 13529 Beach Blvd # 102, Jacksonville, Florida |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1659610392 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
1615 S Congress Ave Ste 105, Delray Beach, FL 33445-6326 Ph: (561) 208-8464 | 13529 Beach Blvd # 102, Jacksonville, FL 32224-0288 Ph: (904) 256-9344 |