Individual provider · NPI-1

Jennifer Eady, LDO

Technician/Technologist, Optician · Lakeland, FL

NPI number1013799295
StatusActive
Last updated in NPPESOct 20, 2023

Details

NPI
1013799295
Entity type
Individual (NPI-1)
Name
Jennifer Eady
Credential
LDO
Sex
Female
Sole proprietor
Yes
Enumeration date
Oct 20, 2023
Certification date
Oct 20, 2023
Last updated
Oct 20, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
156FX1800X Technician/Technologist, OpticianDO4568–Yes

Practice location

3501 S Florida Ave
Lakeland, FL 33803-4860

Phone 863-644-9461

Mailing address

3501 S Florida Ave
Lakeland, FL 33803-4860

Phone 863-644-9461

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