Individual
BRANDON POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2023 PROFESSIONAL CENTER DR, ORANGE PARK, FL 32073-4472
(904) 272-2020
Mailing address
2023 PROFESSIONAL CENTER DR, ORANGE PARK, FL 32073-4472
(904) 272-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC5552
FL
Other
Enumeration date
06/23/2018
Last updated
06/23/2018
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