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General NPI Number Information
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NPI Number | 1003944703
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Entity Type | Individual
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Provider Name | DR. MICHAEL ZWOLINSKI
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Gender | Male
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 06/14/2023
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Provider Practice Location Address
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Address Line | 1815 US HIGHWAY 1 S
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City | ST AUGUSTINE
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State | FL
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Zip | 32084-4240
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Country | US
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Telephone | 904-547-2594
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Fax | 904-547-2644
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Provider Business Mailing Address
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Address Line | 312 2ND ST
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City | ST AUGUSTINE
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State | FL
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Zip | 32084-7307
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Country | US
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Telephone | 904-794-1085
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC2730
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License Number State | FL
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