Individual
COLLEEN M KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
201 N HOGAN ST STE 100, JACKSONVILLE, FL 32202-4203
(904) 356-9431
(904) 356-2969
Mailing address
201 N HOGAN ST STE 100, JACKSONVILLE, FL 32202-4203
(904) 356-9431
(904) 356-2969
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC3718
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0135179
GHI
—
01
—
26115561
UNITED HEALTHCARE
—
01
—
45002
BCBS INDIVIDUAL
FL
01
—
620893200
MEDICAID INDIVIDUAL ID
FL
01
—
7500506
AETNA
FL
01
—
8700204
CIGNA
—
Enumeration date
07/20/2005
Last updated
02/27/2025
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