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Organization
ST JOHNS EYE ASSOCIATES AT NOCATEE
Active
Organization
ST JOHNS EYE ASSOCIATES AT NOCATEE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA MARIE BACKS (CREDENTIALING)
(805) 433-2901
Entity
Organization
Contact information
Practice address
200 NOCATEE VILLAGE DRIVE, PONTE VEDRA, FL 32081
(904) 825-4525
(904) 825-4520
Mailing address
100 MARKETSIDE AVENUE, PONTE VEDRA, FL 32081-0582
(904) 825-4525
(904) 825-4520
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC 3241
FL
Other
Enumeration date
08/28/2012
Last updated
08/19/2022
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