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Individual

DR. MICHAEL ALLEN POWERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
3546 ST JOHNS BLUFF RD S, UNIT 203, JACKSONVILLE, FL 32224
(904) 996-1533
(904) 996-1535
Mailing address
3546 ST JOHNS BLUFF RD S, UNIT 203, JACKSONVILLE, FL 32224
(904) 996-1533
(904) 996-1535

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC3509
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
043609673
TAX IDENTIFICATION NUMBER
FL
01
20725
BCBS
FL
05
620752900
FL
Enumeration date
05/01/2006
Last updated
01/30/2014
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