Individual
ALAN IVAN RAUCHWARGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
9400 ATLANTIC BLVD, 62, JACKSONVILLE, FL 32225-8255
(904) 721-7700
(904) 721-0051
Mailing address
9400 ATLANTIC BLVD, SUITE 62, JACKSONVILLE, FL 32225-8255
(904) 721-7700
(904) 721-0051
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC 1046
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
011047500
—
FL
Enumeration date
07/17/2006
Last updated
02/25/2015
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