# JEROME WEITZEN OD PA

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

## Provider details

- **NPI number:** 1346288339
- **Authorized official:** DR. JEROME WEITZEN OD (PRES)
- **Authorized official phone:** (904) 353-3163

## Contact information

- **Practice address:** 213 N LAURA ST, JACKSONVILLE, FL 32202-3501
- **Practice address phone:** (904) 353-3163
- **Practice address fax:** (904) 355-1813
- **Mailing address:** 213 N LAURA ST, JACKSONVILLE, FL 32202-3501
- **Mailing address phone:** (904) 353-3163
- **Mailing address fax:** (904) 355-1813

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | 700 | FL | Yes |

## Other

- **Enumeration date:** 06/03/2006
- **Last updated:** 07/08/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 084160900 | — | FL |