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Individual

GAYLE P LEINWOHL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
9397 SAN JOSE BLVD, SUITE 2, JACKSONVILLE, FL 32257-5587
(904) 730-2299
(904) 730-2557
Mailing address
9397 SAN JOSE BLVD, SUITE 2, JACKSONVILLE, FL 32257-5587
(904) 730-2299
(904) 730-2557

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC 2993
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
620245401
FL
Enumeration date
07/17/2006
Last updated
11/04/2015
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