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Organization
ST JOHNS EYE ASSOCIATES PA
Active
Organization
ST JOHNS EYE ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA MARIE BACKS (CREDENTIALING MANAGER)
(805) 433-2901
Entity
Organization
Contact information
Practice address
150 VILLAGE COMMONS DR STE A-102, ST AUGUSTINE, FL 32092-4545
(904) 287-9137
(904) 287-9057
Mailing address
161 HAMPTON POINT DR STE 3, ST AUGUSTINE, FL 32092-3058
(904) 287-9137
(904) 287-9057
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
06/24/2022
Last updated
06/24/2022
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