# JERIN JOSEPH OD, PA

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

## Provider details

- **NPI number:** 1437841210
- **Authorized official:** DR. JERIN JOSEPH OD (PRESIDENT)
- **Authorized official phone:** (954) 309-8647

## Contact information

- **Practice address:** 13159 CITY CENTER BLVD SPACE L-104, JACKSONVILLE, FL 32218
- **Practice address phone:** (904) 750-4469
- **Mailing address:** 7643 GATE PKWY STE 104-2, JACKSONVILLE, FL 32256-3092

## Taxonomy

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

## Other

- **Enumeration date:** 05/22/2023
- **Last updated:** 05/22/2023