MEDICARE: OPTIGEN INCORPORATED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	2141	FL

General Provider Information

NPI Number	:	1578592309
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTIGEN INCORPORATED

Provider Business Mailing Address
First Line	:	1351 13TH AVE S
Second Line	:	STE 100
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-3234
Country	:	US
Telephone Number	:	904-249-1046
Fax Number	:	877-339-0180

Provider Business Practice Location Address
First Line	:	1351 13TH AVE S
Second Line	:	STE 100
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-3234
Country	:	US
Telephone Number	:	904-249-1046
Fax Number	:	877-339-0180

Authorized Official
Title or Position	:	CEO
Name	:	JEFFREY BARNHARD
Credential	:	AO
Telephone Number	:	727-530-7700

Provider Enumeration Date	:	07/02/2006
Last Update Date	:	10/09/2025

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