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NPI Code Detail

MEDICARE: DR. MATTHEW COMERFORD O.D.

MEDICARE: DR. MATTHEW COMERFORD O.D.
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
1152W00000XOptometristOPC003703FL

General Provider Information

NPI Number : 1780783191
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MATTHEW COMERFORD O.D.
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 :
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 : 904-997-7013
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2006
Last Update Date : 07/08/2007

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