Provider Demographics
NPI:1104010719
Name:MCCAFFREY, JOYCE ANN (LDO)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:ANN
Last Name:MCCAFFREY
Suffix:
Gender:F
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 E VENICE AVE
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-4635
Mailing Address - Country:US
Mailing Address - Phone:941-486-3577
Mailing Address - Fax:
Practice Address - Street 1:602 E VENICE AVE
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-4635
Practice Address - Country:US
Practice Address - Phone:941-486-3577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2804156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician