Organization
FIRST COAST OPTICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL LUNDBERG (GENERAL MANAGER)
(904) 272-7626
Entity
Organization
Contact information
Practice address
179 COLLEGE DR STE 17, ORANGE PARK, FL 32065-7690
(904) 272-7626
Mailing address
179 COLLEGE DR STE 17, ORANGE PARK, FL 32065-7690
(904) 272-7626
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
10/05/2016
Last updated
10/05/2016
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