Organization
FOUR H OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MAUDE LUCILLE HOUGH (OWNER)
(352) 377-0532
Entity
Organization
Contact information
Practice address
2441 NW 43RD ST, SUITE 2C, GAINESVILLE, FL 32606-7469
(352) 377-0532
(352) 338-8001
Mailing address
4605 NW 6TH ST, SUITE 2C, GAINESVILLE, FL 32609-4197
(352) 377-0532
(352) 338-8001
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
3940
FL
156FX1800X
Optician
5019
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
630303001
—
FL
Enumeration date
11/05/2008
Last updated
08/21/2015
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