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General NPI Number Information
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NPI Number | 1184197394
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Entity Type | Organization
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Legal Business Name | UNIVERSITY EYE CENTER, LLC
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Dates
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Enumeration Date | 01/10/2019
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Last Update Date | 01/08/2022
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Provider Practice Location Address
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Address Line | 8 UNF DR STE 238
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City | JACKSONVILLE
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State | FL
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Zip | 32224-7699
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Country | US
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Telephone | 904-853-0767
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Fax |
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Provider Business Mailing Address
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Address Line | 8 UNF DR STE 238
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City | JACKSONVILLE
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State | FL
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Zip | 32224-7699
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Country | US
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Telephone | 904-853-0767
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. L L
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Credential |
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Telephone | 904-620-4393
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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 |
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License Number State |
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