| NPI | 1255361416 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAYLE P LEINWOHL President/ Physician 904-730-2299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC 1046) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2015-09-16 |