# GREGORY L. KANE OD PA

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

## Provider details

- **NPI number:** 1760613368
- **Authorized official:** WENDY BAGGETT LDO (OPTICIAN)
- **Authorized official phone:** (386) 328-8387

## Contact information

- **Practice address:** 514 S PALM AVE, PALATKA, FL 32177-4148
- **Practice address phone:** (386) 328-8387
- **Practice address fax:** (386) 325-0644
- **Mailing address:** 514 S PALM AVE, PALATKA, FL 32177-4148
- **Mailing address phone:** (386) 328-8387
- **Mailing address fax:** (386) 325-0644

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | OP-0001874 | FL | Yes |

## Other

- **Enumeration date:** 07/30/2009
- **Last updated:** 07/30/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 078282300 | — | FL |