Reardon, Patrick L

Reardon, Patrick L is an individual health care provider with primary practice located at 961 Cesery Blvd , Jacksonville FL 32211-5607. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Reardon, Patrick L can be contacted via phone (904) 743-9955.

Contact Information

Primary practice address
961 Cesery Blvd Jacksonville FL 32211-5607
Phone: (904) 743-9955
Fax: (904) 743-2802
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OPC 998 Florida

Profile Details

NPI number 1831189646
LBN Legal business name Reardon, Patrick L
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 24th, 2005
Last updated Sep 19th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831189646 NPPES
Florida MEDICAID 078642000
Florida Other 19736
Florida Other 114979

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