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Organization

FLEMING ISLAND 2020 PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SHAROKH KAPADIA OD (OWNER)
(904) 287-9137
Entity
Organization

Contact information

Practice address
1505 COUNTY ROAD 220, ORANGE PARK, FL 32003-7926
(904) 215-3005
Mailing address
161 HAMPTON POINT DR, SUITE 3, ST AUGUSTINE, FL 32092-3057
(904) 287-9137

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC3241
FL
152W00000X
Optometrist
OPC3594
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
620800200
FL
05
620801100
FL
Enumeration date
06/02/2008
Last updated
02/03/2010
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