Provider Demographics
NPI:1518000959
Name:HOLLANDER, MAURY JAY (OD)
Entity Type:Individual
Prefix:DR
First Name:MAURY
Middle Name:JAY
Last Name:HOLLANDER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9501 ARLINGTON EXPY
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-8200
Mailing Address - Country:US
Mailing Address - Phone:904-724-7707
Mailing Address - Fax:904-720-0471
Practice Address - Street 1:9501 ARLINGTON EXPY
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32225-8200
Practice Address - Country:US
Practice Address - Phone:904-724-7707
Practice Address - Fax:904-720-0471
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1095152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT-13880Medicare UPIN