| |
3720 Curtis Blvd # 106-108, Port St John, FL 32927-3961 | |
(321) 639-0910 | |
(321) 635-9227 |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 3720 Curtis Blvd # 106-108, Port St John, Florida |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1467057497 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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8614 Westwood Center Dr Fl 9, Vienna, VA 22182-2442 Ph: (703) 847-8899 | 3720 Curtis Blvd # 106-108, Port St John, FL 32927-3961 Ph: (321) 639-0910 |