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General NPI Number Information
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NPI Number | 1104174564
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Entity Type | Individual
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Provider Name | MARY ARMANIOUS HENDY O.D.
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Gender | Female
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Dates
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Enumeration Date | 08/16/2012
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Last Update Date | 08/18/2017
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Provider Practice Location Address
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Address Line | 7077 NORMANDY BLVD
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City | JACKSONVILLE
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State | FL
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Zip | 32205-6279
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Country | US
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Telephone | 904-781-7717
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Fax |
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Provider Business Mailing Address
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Address Line | 212 STATE RD 312
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City | ST. AUGUSTINE
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State | FL
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Zip | 32086
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Country | US
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Telephone |
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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 | OPC 4692
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License Number State | FL
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