Couzens Stam Domingo Pa

NPI 1003955568 - Optometrist - 152W00000X

NPI Details
NPI 1003955568
Enumeration Date 02/05/2007
Last Updated 11/16/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name BRYAN ANDREW BRYAN
Position PRESIDENT
Phone (904) 246-4831
Fax (904) 249-5876
Practice Location
905 BEACH BLVD
SUITE B
JACKSONVILLE BEACH FL, 32250-4303, US
Phone (904) 246-4831
Fax (904) 249-5876
Business Location
905 BEACH BLVD
SUITE B
JACKSONVILLE BEACH FL, 32250-4303, US
Phone (904) 246-4831
Fax (904) 249-5876
Toxanomy
Taxonomy Code 152W00000X
License State Florida
License Number OPC 3453
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According to our database, Couzens Stam Domingo Pa NPI is 1003955568, taxonomy code is 152W00000X and license number is OPC 3453, license state is located at Florida. Couzens Stam Domingo Pa physically located at 905 Beach Blvd, Jacksonville Beach FL, 32250-4303. NPI Number 1033115704 has the healthcare provider type.

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1003955568 NPI number is provided on an as is basis without warranty of any kind. 1003955568 is maintained by the National Plan & Provider Enumeration System. The contents of Couzens Stam Domingo Pa are for informational purposes only.