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General NPI Number Information
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NPI Number | 1396021663
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Entity Type | Organization
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Legal Business Name | DIANE MARIE CATES, O.D., P.A.
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Dates
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Enumeration Date | 10/31/2011
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Last Update Date | 10/21/2013
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Provider Practice Location Address
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Address Line | 2036 FORBES ST
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City | JACKSONVILLE
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State | FL
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Zip | 32204-3802
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Country | US
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Telephone | 904-330-0466
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Fax |
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Provider Business Mailing Address
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Address Line | 12461 MARIAH ANN CT S
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City | JACKSONVILLE
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State | FL
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Zip | 32225-2674
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Country | US
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Telephone | 904-220-6421
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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. DIANE MARIE CATES
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Credential | O.D.
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Telephone | 904-220-6421
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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 | OPC2901
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License Number State | FL
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