Provider Demographics
NPI:1033211594
Name:COLLEY, FLOYD DONALD (OD)
Entity Type:Individual
Prefix:DR
First Name:FLOYD
Middle Name:DONALD
Last Name:COLLEY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:F
Other - Middle Name:DONALD
Other - Last Name:COLLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:2105 TOWN ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32505-5117
Mailing Address - Country:US
Mailing Address - Phone:850-433-0327
Mailing Address - Fax:850-432-2159
Practice Address - Street 1:2105 TOWN ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32505-5117
Practice Address - Country:US
Practice Address - Phone:850-433-0327
Practice Address - Fax:850-432-2159
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL811152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL084263000Medicaid
FL19097Medicare ID - Type Unspecified