Healthcare Provider Details

I. General information

NPI: 1144133497
Provider Name (Legal Business Name): RONALD DAVID JENKINS II LDO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7810 W COLONIAL DR
ORLANDO FL
32818-6674
US

IV. Provider business mailing address

2716 LINWOOD PL
ORLANDO FL
32803-6705
US

V. Phone/Fax

Practice location:
  • Phone: 407-532-5154
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number5657
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: