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General NPI Number Information
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NPI Number | 1083887400
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Entity Type | Organization
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Legal Business Name | MICHAEL S NASON OD PA
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Dates
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Enumeration Date | 04/07/2008
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Last Update Date | 03/17/2022
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Provider Practice Location Address
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Address Line | 4415 SIDEWINDER TRL
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City | MIDDLEBURG
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State | FL
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Zip | 32068-3250
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Country | US
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Telephone | 561-951-7285
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Fax |
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Provider Business Mailing Address
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Address Line | 4415 SIDEWINDER TRL
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City | MIDDLEBURG
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State | FL
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Zip | 32068-3250
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Country | US
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Telephone | 561-951-7285
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL S. NASON
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Credential | O.D.
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Telephone | 561-951-7285
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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 | OPC002692
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License Number State | FL
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