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Organization
BEACHES EYE CENTER, PA
Active
Organization
BEACHES EYE CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD DWIGHT TEN HULZEN M.D. (PRESIDENT)
(904) 246-3937
Entity
Organization
Contact information
Practice address
1351 13TH AVE S, SUITE 120-A, JACKSONVILLE BEACH, FL 32250
(904) 246-3937
(904) 242-0415
Mailing address
1351 13TH AVE S, SUITE 120-A, JACKSONVILLE BEACH, FL 32250-3234
(904) 246-3937
(904) 242-0415
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME0080332
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
258859500
—
FL
Enumeration date
10/06/2009
Last updated
08/01/2018
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