Individual
MICHAEL L HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1900 MASON AVE, SUITE 100, DAYTONA BEACH, FL 32117-5103
(386) 274-5525
(386) 274-5585
Mailing address
1900 MASON AVE, SUITE 100, DAYTONA BEACH, FL 32117-5103
(386) 274-5525
(386) 274-5585
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OP1839
FL
152WC0802X
Corneal and Contact Management Optometrist
OPC1839
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078920801
—
FL
01
—
21851
BCBS
FL
Enumeration date
06/24/2005
Last updated
08/01/2012
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