Provider Demographics
NPI:1821207903
Name:DR. ANUP K PANJWANI AND ASSOCIATES
Entity Type:Organization
Organization Name:DR. ANUP K PANJWANI AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANUP
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:PANJWANI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:904-997-7799
Mailing Address - Street 1:7647 WEXFORD CLUB DR W
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-2311
Mailing Address - Country:US
Mailing Address - Phone:904-997-7799
Mailing Address - Fax:904-721-1319
Practice Address - Street 1:SEARS OPTICAL
Practice Address - Street 2:9501 ARLINGTON EXPRESSWAY
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32225
Practice Address - Country:US
Practice Address - Phone:904-721-1319
Practice Address - Fax:904-721-1319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3506152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty