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General NPI Number Information
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NPI Number | 1326372061
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Entity Type | Organization
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Legal Business Name | EYES ON OAKLEAF, P A
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Dates
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Enumeration Date | 09/29/2009
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Last Update Date | 11/27/2009
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Provider Practice Location Address
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Address Line | 9560 CROSSHILL BLVD STE 106
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City | JACKSONVILLE
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State | FL
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Zip | 32222-5827
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Country | US
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Telephone | 904-777-2927
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Fax | 904-777-4047
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Provider Business Mailing Address
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Address Line | 9560 CROSSHILL BLVD STE 106
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City | JACKSONVILLE
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State | FL
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Zip | 32222-5827
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Country | US
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Telephone | 904-777-2927
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Fax | 904-777-4047
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | DR. HANAA MALIK HABASHI
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Credential | O.D.
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Telephone | 904-994-0458
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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 | OPC3588
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License Number State | FL
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