Organization
OSCEOLA OPTIQUE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEWELL RENEE CHANG OD (PRESIDENT)
(772) 334-4264
Entity
Organization
Contact information
Practice address
3201 NE SKYLINE DR, SUITE D, JENSEN BEACH, FL 34957-3912
(772) 334-4264
(772) 334-4265
Mailing address
3201 NE SKYLINE DR, SUITE D, JENSEN BEACH, FL 34957-3912
(772) 334-4264
(772) 334-4265
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
OPC2950
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20621
BLUE CROSS BLUE SHIELD
—
Enumeration date
03/15/2007
Last updated
12/04/2008
Update your record
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