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General NPI Number Information
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NPI Number | 1710232350
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Entity Type | Organization
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Legal Business Name | R & J NEBB, O.D., P.A.
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Dates
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Enumeration Date | 07/19/2012
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Last Update Date | 07/19/2012
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Provider Practice Location Address
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Address Line | 4400 N STATE ROAD 7
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City | CORAL SPRINGS
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State | FL
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Zip | 33073-3353
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Country | US
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Telephone | 954-372-1301
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Fax |
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Provider Business Mailing Address
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Address Line | 940 SWEETWATER LN #505
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City | BOCA RATON
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State | FL
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Zip | 33431-7132
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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 | CO-OWNER
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Name | DR. JONATHAN NEBB
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Credential | O.D.
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Telephone | 703-447-1644
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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 | OPC4357
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC4452
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License Number State | FL
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