Marc Jay Gannon Optometrist Pa

LBN: Marc Jay Gannon Optometrist Pa
Marc Jay Gannon Optometrist Pa is an health care organization with primary practice located at 2021 E Commercial Blvd 301, Fort Lauderdale FL 33308-3763. The organization recently has only one registered license in Eye and Vision Services Providers / Low Vision Rehabilitation, which is considered as the primary health care specialty. Marc Jay Gannon Optometrist Pa can be contacted via phone (954) 776-5223, or through Gannon, Marc Jay via phone (954) 776-5223.

Contact Information

Primary practice address
2021 E Commercial Blvd 301 Fort Lauderdale FL 33308-3763
Phone: (954) 776-5223
Fax: (954) 491-0027
Website:
Map and Directions
Authorized official contact:
Name: Gannon, Marc Jay Doctor of Optometry (OD)
Phone: (954) 776-5223

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Low Vision Rehabilitation 152WL0500X OPC1271 Florida

Profile Details

NPI number 1194974782
LBN Legal business name Marc Jay Gannon Optometrist Pa
DBA Doing business as
Authorized official Gannon, Marc Jay Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 18th, 2008
Last updated Aug 4th, 2009 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194974782 NPPES
Florida MEDICAID 078390100

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