Individual
MARY J AYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1515 BUSINESS CENTER DR STE 4, FLEMING ISLAND, FL 32003-4401
(904) 278-1760
(904) 278-1730
Mailing address
1515 BUSINESS CENTER DR STE 4, FLEMING ISLAND, FL 32003-4401
(904) 278-1760
(904) 278-1730
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC2012
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410027569
RR MEDICARE
—
01
—
593252808
TAX ID
—
Enumeration date
02/22/2006
Last updated
02/12/2009
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