Provider Demographics
NPI:1790897155
Name:DR. CARVELL AND ASSOCIATES, PA
Entity Type:Organization
Organization Name:DR. CARVELL AND ASSOCIATES, PA
Other - Org Name:DR. CARVELL AND ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:CARVELL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:904-777-3937
Mailing Address - Street 1:5921 COLLINS RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-5801
Mailing Address - Country:US
Mailing Address - Phone:904-777-3937
Mailing Address - Fax:904-777-8208
Practice Address - Street 1:5921 COLLINS RD
Practice Address - Street 2:SUITE 1
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32244-5801
Practice Address - Country:US
Practice Address - Phone:904-777-3937
Practice Address - Fax:904-777-8208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
33476OtherDAVISVISION
=========OtherAETNA
=========OtherCIGNA
=========OtherBLUE CROSS BLUE SHIELD
=========OtherTRICARE
=========OtherCOMP BENEFITS
=========OtherVISION SERVICE PLAN
FL72814Medicare PIN
=========OtherCIGNA