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General NPI Number Information
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NPI Number | 1225141203
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Entity Type | Organization
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Legal Business Name | DR AKEL & FAVALE PL
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 06/13/2016
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Provider Practice Location Address
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Address Line | 953 LANE AVE S
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City | JACKSONVILLE
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State | FL
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Zip | 32205-4706
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Country | US
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Telephone | 904-786-4442
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Fax | 904-786-2515
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Provider Business Mailing Address
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Address Line | 953 LANE AVE S
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City | JACKSONVILLE
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State | FL
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Zip | 32205-4706
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Country | US
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Telephone | 904-786-4442
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Fax | 904-786-2515
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANTHONY FRANK FAVALE II
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Credential | O.D.
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Telephone | 904-786-4442
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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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