# PATRICK L REARDON OD

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

## Provider details

- **NPI number:** 1588054324
- **Authorized official:** DR. PATRICK REARDON O.D. (OWNER)
- **Authorized official phone:** (904) 743-9955

## Contact information

- **Practice address:** 961 CESERY BLVD, JACKSONVILLE, FL 32211-5678
- **Practice address phone:** (904) 743-9955
- **Practice address fax:** (904) 743-2802
- **Mailing address:** 961 CESERY BLVD, JACKSONVILLE, FL 32211-5678
- **Mailing address phone:** (904) 743-9955
- **Mailing address fax:** (904) 743-2802

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | OPC998 | FL | Yes |

## Other

- **Enumeration date:** 02/02/2015
- **Last updated:** 02/02/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 078642000 | — | FL |
| 01 | — | 114979 | EYEMED | FL |
| 01 | — | 19736 | FLORIDA BLUE | FL |