Basic Information
| Provider Information | |||||||||
| NPI: | 1558416412 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | A1A FAMILY EYE CARE, INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | ROWE FAMILY EYECARE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4788 HODGES BOULAVARD | ||||||||
| Address2: | UNIT 205 | ||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322247223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9049929991 | ||||||||
| FaxNumber: | 9049929997 | ||||||||
| Practice Location | |||||||||
| Address1: | 4788 HODGES BLVD | ||||||||
| Address2: | UNIT 205 | ||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32224 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9049929991 | ||||||||
| FaxNumber: | 9049929997 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2007 | ||||||||
| LastUpdateDate: | 08/29/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | HORNING | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
| AuthorizedOfficialMiddleName: | ANTHONY | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9049929991 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | O.D. | ||||||||
| NPICertificationDate: | 08/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | OPC1749 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist |
No ID Information.