Organization
OPTIMAL JACKSONVILLE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON BRETT HALEY (VP)
(616) 429-0957
Entity
Organization
Contact information
Practice address
6138 KENNERLY RD, SUITE 101, JACKSONVILLE, FL 32216-4393
(904) 733-7770
Mailing address
3803 BEDFORD AVE, #103, NASHVILLE, TN 37215-2564
(904) 733-7770
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
10/22/2014
Last updated
10/22/2014
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