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General NPI Number Information
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NPI Number | 1700857158
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Entity Type | Individual
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Provider Name | JOANNE FORD REED OD
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Gender | Female
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Dates
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Enumeration Date | 02/01/2006
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Last Update Date | 03/11/2013
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Provider Practice Location Address
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Address Line | 124 TUSCAN WAY STE 104
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City | ST AUGUSTINE
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State | FL
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Zip | 32092-1851
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Country | US
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Telephone | 904-547-2691
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Fax | 904-547-2695
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Provider Business Mailing Address
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Address Line | 124 TUSCAN WAY SUITE 104
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City | ST AUGUSTINE
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State | FL
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Zip | 32092-1851
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Country | US
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Telephone | 904-547-2691
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Fax | 904-547-2695
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | OPC003043
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License Number State | FL
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