Provider Demographics
NPI:1477690709
Name:MINESINGER, JAMES HARRY (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:HARRY
Last Name:MINESINGER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:260 S LAWRENCE BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:KEYSTONE HEIGHTS
Mailing Address - State:FL
Mailing Address - Zip Code:32656-9217
Mailing Address - Country:US
Mailing Address - Phone:352-473-2600
Mailing Address - Fax:532-473-2633
Practice Address - Street 1:260 S LAWRENCE BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:KEYSTONE HEIGHTS
Practice Address - State:FL
Practice Address - Zip Code:32656-9217
Practice Address - Country:US
Practice Address - Phone:352-473-2600
Practice Address - Fax:532-473-2633
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC994152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL19489Medicare ID - Type Unspecified