Lundquist, Fred A

Lundquist, Fred A is an individual health care provider with primary practice located at 502 E. New Haven Ave. , Melbourne FL 32901-5427. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Lundquist, Fred A can be contacted via phone (321) 727-2020.

Contact Information

Primary practice address
502 E. New Haven Ave. Melbourne FL 32901-5427
Phone: (321) 727-2020
Fax: (321) 984-9547
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OPC924 Florida

Profile Details

NPI number 1184675415
LBN Legal business name Lundquist, Fred A
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2006
Last updated Nov 15th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184675415 NPPES
Florida Other 2885280 AETNA HMO
Florida Other 4325330 AETNA HMO
Florida MEDICAID 620734100 AETNA HMO
Florida Other 19983 AETNA HMO
Florida Other 410047717 AETNA HMO
Florida Other 528645500 AETNA HMO

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