=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982790341
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | F & M OF MILTON INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/05/2006
-----------------------------------------------------
Last Update Date | 02/26/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5560 STEWART ST
-----------------------------------------------------
City | MILTON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32570-4304
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 850-623-2545
-----------------------------------------------------
Fax | 850-623-3123
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5560 STEWART ST
-----------------------------------------------------
City | MILTON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32570-4304
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 850-623-2545
-----------------------------------------------------
Fax | 850-623-3123
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. FRANKLIN A JOSLIN
-----------------------------------------------------
Credential | O.D.
-----------------------------------------------------
Telephone | 850-623-2545
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------