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General NPI Number Information
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NPI Number | 1477089845
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Entity Type | Organization
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Legal Business Name | SIGHTHEALTH PRIMARY EYECARE, PA
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Dates
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Enumeration Date | 05/04/2017
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Last Update Date | 03/22/2021
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Provider Practice Location Address
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Address Line | 140 GATEWAY CIR UNIT 5
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City | JACKSONVILLE
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State | FL
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Zip | 32259-4085
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Country | US
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Telephone | 904-217-7099
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 550961
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City | JACKSONVILLE
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State | FL
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Zip | 32255-0961
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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 | PRESIDENT
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Name | DR. JENILEE REBARBER
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Credential | OD
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Telephone | 904-217-7099
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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 4962
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License Number State | FL
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