Healthcare Provider Details

I. General information

NPI: 1578592309
Provider Name (Legal Business Name): OPTIGEN INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8641 BAYPINE RD STE 3
JACKSONVILLE FL
32256-7515
US

IV. Provider business mailing address

8641 BAYPINE RD STE 3
JACKSONVILLE FL
32256-7515
US

V. Phone/Fax

Practice location:
  • Phone: 904-249-1046
  • Fax: 877-339-0180
Mailing address:
  • Phone: 904-249-1046
  • Fax: 877-339-0180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number2141
License Number StateFL

VIII. Authorized Official

Name: JEFFREY BARNHARD
Title or Position: CEO
Credential: AO
Phone: 727-530-7700