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Organization
PATRICK L REARDON OD
Active
Organization
PATRICK L REARDON OD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICK REARDON O.D. (OWNER)
(904) 743-9955
Entity
Organization
Contact information
Practice address
961 CESERY BLVD, JACKSONVILLE, FL 32211-5678
(904) 743-9955
(904) 743-2802
Mailing address
961 CESERY BLVD, JACKSONVILLE, FL 32211-5678
(904) 743-9955
(904) 743-2802
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC998
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078642000
—
FL
01
—
114979
EYEMED
FL
01
—
19736
FLORIDA BLUE
FL
Enumeration date
02/02/2015
Last updated
02/02/2015
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