Organization
EYE-STYLE OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JADE JACKSON L.D.O (OWNER)
(386) 446-4210
Entity
Organization
Contact information
Practice address
7 OLD KINGS RD N STE 32, PALM COAST, FL 32137-8247
(386) 446-4210
(386) 445-7309
Mailing address
7 OLD KINGS RD N STE 32, PALM COAST, FL 32137-8247
(386) 446-4210
(386) 445-7309
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DO3668
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OP0463
EYEMED PROVIDER ID#
FL
Enumeration date
01/16/2007
Last updated
08/22/2020
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