Healthcare Provider Details

I. General information

NPI: 1538081526
Provider Name (Legal Business Name): DINEEN HELEN WOLFERSHEIM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3075 CALDER DR
JACKSONVILLE BEACH FL
32250-1650
US

IV. Provider business mailing address

3075 CALDER DR
JACKSONVILLE BEACH FL
32250-1650
US

V. Phone/Fax

Practice location:
  • Phone: 904-788-9792
  • Fax:
Mailing address:
  • Phone: 904-788-9792
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License NumberOD8230
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: