| |
1008 Park Ave, Suite 140, Orange Park, FL 32073-4112 | |
(904) 215-4600 | |
(904) 215-4620 |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 1008 Park Ave, Orange Park, Florida |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1710381876 | NPI | - | NPPES |
253273500 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
1008 Park Ave, Suite 140, Orange Park, FL 32073-4112 Ph: (904) 215-4600 | 1008 Park Ave, Suite 140, Orange Park, FL 32073-4112 Ph: (904) 215-4600 |