Organization
FOUR H OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MAUDE LUCILLE HOUGH (OWNER)
(352) 377-0532
Entity
Organization
Contact information
Practice address
4605 NW 6TH ST, SUITE 2C, GAINESVILLE, FL 32609-4197
(352) 377-0532
(352) 338-8001
Mailing address
4605 NW 6TH ST, SUITE 2C, GAINESVILLE, FL 32609-4197
(352) 377-0532
(352) 338-8001
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
5019
FL
332H00000X
Eyewear Supplier
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
630303000
—
FL
Enumeration date
03/20/2007
Last updated
10/28/2008
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