MEDICARE: A1A FAMILY EYECARE

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
1	152W00000X	Optometrist	OPC1749	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770622276
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A1A FAMILY EYECARE

Provider Business Mailing Address
First Line	:	1835 US 1 SOUTH, UNIT 121
Second Line	:
City	:	ST. AUGUSTINE
State	:	FL
Zip	:	32084
Country	:	US
Telephone Number	:	904-824-0212
Fax Number	:	904-824-0132

Provider Business Practice Location Address
First Line	:	1835 US 1 SOUTH, UNIT 121
Second Line	:
City	:	ST. AUGUSTINE
State	:	FL
Zip	:	32084
Country	:	US
Telephone Number	:	904-824-0212
Fax Number	:	904-824-0132

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JAMES ANTHONY HORNING
Credential	:	O.D.
Telephone Number	:	604-824-0212

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	03/17/2018

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Directions to “A1A FAMILY EYECARE ” Practice Location

Language	Start Address	Practice Location

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