Organization
JEROME WEITZEN OD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEROME WEITZEN OD (PRES)
(904) 353-3163
Entity
Organization
Contact information
Practice address
213 N LAURA ST, JACKSONVILLE, FL 32202-3501
(904) 353-3163
(904) 355-1813
Mailing address
213 N LAURA ST, JACKSONVILLE, FL 32202-3501
(904) 353-3163
(904) 355-1813
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
700
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
084160900
—
FL
Enumeration date
06/03/2006
Last updated
07/08/2009
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