# AEG FLORIDA PROFESSIONAL PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164156246
- **Authorized official:** MELISSA ALLISON (SENIOR DIRECTOR RCM/MVC)
- **Authorized official phone:** (618) 462-9818

## Contact information

- **Practice address:** 4788 HODGES BLVD STE 205, JACKSONVILLE, FL 32224-7223
- **Practice address phone:** (904) 992-9991
- **Mailing address:** 111 E 4TH ST STE 440, ALTON, IL 62002-6241
- **Mailing address phone:** (618) 462-9818
- **Mailing address fax:** (314) 741-4947

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | Yes |
| 152W00000X | Optometrist | — | — | Yes |

## Other

- **Enumeration date:** 07/13/2022
- **Last updated:** 07/13/2022