Provider Demographics
NPI:1326372061
Name:EYES ON OAKLEAF, P A
Entity Type:Organization
Organization Name:EYES ON OAKLEAF, P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HANAA
Authorized Official - Middle Name:MALIK
Authorized Official - Last Name:HABASHI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:904-994-0458
Mailing Address - Street 1:9560 CROSSHILL BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32222-5827
Mailing Address - Country:US
Mailing Address - Phone:904-777-2927
Mailing Address - Fax:904-777-4047
Practice Address - Street 1:9560 CROSSHILL BLVD STE 106
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32222-5827
Practice Address - Country:US
Practice Address - Phone:904-777-2927
Practice Address - Fax:904-777-4047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-29
Last Update Date:2009-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3588152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty