# LAKE CITY VISION PA

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

## Provider details

- **NPI number:** 1427426469
- **Authorized official:** WILLIAM A COLE O.D. (PRESIDENT)
- **Authorized official phone:** (386) 755-2400

## Contact information

- **Practice address:** 295 NW COMMONS LOOP STE 105, LAKE CITY, FL 32055-7709
- **Practice address phone:** (386) 755-2400
- **Mailing address:** 295 NW COMMONS LOOP STE 105, LAKE CITY, FL 32055-7709
- **Mailing address phone:** (386) 755-2400

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | OPC3103 | FL | Yes |

## Other

- **Enumeration date:** 09/08/2015
- **Last updated:** 09/08/2015