Individual
BRYAN ANDREW STAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
10915 BAYMEADOWS RD STE 110, JACKSONVILLE, FL 32256-9131
(904) 647-9655
(904) 647-9611
Mailing address
10915 BAYMEADOWS RD STE 110, JACKSONVILLE, FL 32256-9131
(904) 647-9655
(904) 647-9611
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC 3453
FL
152WV0400X
Vision Therapy Optometrist
OPC 3453
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
620556900
—
FL
05
—
620603400
—
FL
Enumeration date
07/19/2005
Last updated
07/14/2026
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