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Organization
FIRST COAST RETINA CENTER PA
Active
Organization
FIRST COAST RETINA CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH RAPPAPORT (CEO)
(904) 997-1100
Entity
Organization
Contact information
Practice address
8833 PERIMETER PARK BLVD, SUITE 203, JACKSONVILLE, FL 32216-1109
(904) 997-1100
Mailing address
8833 PERIMETER PARK BLVD, SUITE 203, JACKSONVILLE, FL 32216-1109
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Enumeration date
10/18/2005
Last updated
06/18/2013
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