| Gateway Vision Inc | |
|
447 Atlantic Blvd, Suite # 1, Atlantic Beach, FL 32233-4004 | |
| (904) 247-0211 | |
| (904) 246-6115 |
| Full Name | Gateway Vision Inc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 447 Atlantic Blvd, Atlantic Beach, Florida |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205885886 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | OPC002051 (Florida) | Primary |
| Provider Name | Richard S Grimshaw |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1912963877 PECOS PAC ID: 3072525021 Enrollment ID: I20060717000244 |
| Provider Name | Mark A Popp |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1225089295 PECOS PAC ID: 4981616935 Enrollment ID: I20060717000265 |
| Provider Name | Matthew D Sutton |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1245616317 PECOS PAC ID: 0244540896 Enrollment ID: I20151110002704 |
| Provider Name | Amanda Kovacs |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1588199806 PECOS PAC ID: 0042579153 Enrollment ID: I20180118001042 |
| Provider Name | Jay R Harrelson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1700235173 PECOS PAC ID: 4284980244 Enrollment ID: I20180705000306 |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway Vision Inc 447 Atlantic Blvd, Suite # 1, Atlantic Beach, FL 32233-4004 Ph: (904) 247-0211 | Gateway Vision Inc 447 Atlantic Blvd, Suite # 1, Atlantic Beach, FL 32233-4004 Ph: (904) 247-0211 |
Mark Alan Popp, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 447 Atlantic Blvd, Atlantic Beach, FL 32233 Phone: 904-247-0211 Fax: 904-246-6115 | |
Dr. Amanda Rose Kovacs, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 447 Atlantic Blvd Ste 1, Atlantic Beach, FL 32233 Phone: 904-247-0211 |