Provider Demographics
NPI:1558416412
Name:A1A FAMILY EYE CARE, INC
Entity Type:Organization
Organization Name:A1A FAMILY EYE CARE, INC
Other - Org Name:ROWE FAMILY EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:HORNING
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:904-992-9991
Mailing Address - Street 1:4788 HODGES BOULAVARD
Mailing Address - Street 2:UNIT 205
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-7223
Mailing Address - Country:US
Mailing Address - Phone:904-992-9991
Mailing Address - Fax:904-992-9997
Practice Address - Street 1:4788 HODGES BLVD
Practice Address - Street 2:UNIT 205
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224
Practice Address - Country:US
Practice Address - Phone:904-992-9991
Practice Address - Fax:904-992-9997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC1749152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL078411700Medicaid
FL078411700Medicaid