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NPI Code Detail

MEDICARE: COMERFORD OPTOMETRY INC

MEDICARE: COMERFORD OPTOMETRY INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristOPC3703FL

General Provider Information

NPI Number : 1508066333
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMERFORD OPTOMETRY INC
Provider Business Mailing Address
First Line : 360 ROSCOE BLVD N
Second Line :
City : PONTE VEDRA BEACH
State : FL
Zip : 32082-2144
Country : US
Telephone Number : 904-543-0881
Fax Number :
Provider Business Practice Location Address
First Line : 4901 GATE PKWY
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32246-4405
Country : US
Telephone Number : 904-564-9511
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. MATTHEW COMERFORD
Credential :
Telephone Number : 904-564-9511
Provider Enumeration Date : 07/19/2007
Last Update Date : 07/19/2007

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Directions to “COMERFORD OPTOMETRY INC ” Practice Location

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