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NPI Code Detail

MEDICARE: DANA M NOLAN OD PA

MEDICARE: DANA M NOLAN OD PA
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
1152W00000XOptometristOPC003292FL

General Provider Information

NPI Number : 1952574246
Entity Type Code : Organization
Provider Name (Legal Business Name) : DANA M NOLAN OD PA
Provider Business Mailing Address
First Line : 3588 SAINT JOHNS AVE
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32205-8446
Country : US
Telephone Number : 904-388-7767
Fax Number : 904-388-0067
Provider Business Practice Location Address
First Line : 3588 SAINT JOHNS AVE
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32205-8446
Country : US
Telephone Number : 904-388-7767
Fax Number : 904-388-0067
Authorized Official
Title or Position : PRESIDENT
Name : DR. DANA MARIE NOLAN
Credential : OD
Telephone Number : 904-388-7767
Provider Enumeration Date : 04/08/2008
Last Update Date : 09/24/2012

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Directions to “DANA M NOLAN OD PA ” Practice Location

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