Individual
OMAR GAYASADDIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
7051 SOUTHPOINT PKWY S STE 300, JACKSONVILLE, FL 32216-8713
(904) 398-2720
(904) 398-6408
Mailing address
11945 SAN JOSE BLVD STE 300, JACKSONVILLE, FL 32223-1627
(904) 396-1725
(904) 396-4893
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
OS13365
FL
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
Primary
OS13365
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
150K9
BCBS-FL
FL
01
—
NS468
MEDICARE
FL
01
—
Q00073252
RAILROAD MEDICARE
FL
Enumeration date
06/16/2010
Last updated
05/27/2022
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