Healthcare Provider Details

I. General information

NPI: 1295856516
Provider Name (Legal Business Name): UNIVERSITY OPTICIANS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 SW 4TH AVE
GAINESVILLE FL
32601-6550
US

IV. Provider business mailing address

300 SW 4TH AVE
GAINESVILLE FL
32601-6550
US

V. Phone/Fax

Practice location:
  • Phone: 352-378-4480
  • Fax: 352-377-5710
Mailing address:
  • Phone: 352-378-4480
  • Fax: 352-377-5710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1100X
TaxonomyOphthalmic Technician/Technologist
License NumberME0011225
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code156FX1800X
TaxonomyOptician
License NumberOE0000041
License Number StateFL

VIII. Authorized Official

Name: MR. FREDRIK D. WOOD
Title or Position: OPTICIAN
Credential: D.O.
Phone: 352-378-4480