Individual
LAURA JANKIPRASAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
7077 NORMANDY BLVD, JACKSONVILLE, FL 32205-6279
(904) 781-7717
Mailing address
7077 NORMANDY BLVD, JACKSONVILLE, FL 32205-6279
(904) 781-7717
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5395
FL
152W00000X
Optometrist
OPC5395
FL
207W00000X
Ophthalmology Physician
5395
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/24/2017
Last updated
08/21/2019
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