| NPI | 1417269549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK J DOMINGO President 904-996-0200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL opc3445) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL opc3440) |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2010-07-06 |