Individual
KENNETH PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
832 NW 57TH ST, GAINESVILLE, FL 32605-6415
(352) 331-7771
(352) 331-4302
Mailing address
832 NW 57TH ST, GAINESVILLE, FL 32605-6415
(352) 331-7771
(352) 331-7771
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC6008
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/27/2021
Last updated
01/06/2022
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