Individual
DR. PATRICK L REARDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
961 CESERY BLVD, JACKSONVILLE, FL 32211-5607
(904) 743-9955
(904) 743-2802
Mailing address
961 CESERY BLVD, JACKSONVILLE, FL 32211-5607
(904) 743-9955
(904) 743-2802
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC 998
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078642000
—
FL
01
—
114979
EYEMED
FL
01
—
19736
BLUE CROSS BLUE SHIELD
FL
Enumeration date
10/24/2005
Last updated
09/19/2024
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