Provider Demographics
NPI:1740207182
Name:BRIAN S ARMITAGE, O.D., P.A.
Entity type:Organization
Organization Name:BRIAN S ARMITAGE, O.D., P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:ARMITAGE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:904-739-2050
Mailing Address - Street 1:8081 PHILIPS HWY
Mailing Address - Street 2:SUITE 9
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-7464
Mailing Address - Country:US
Mailing Address - Phone:904-739-2050
Mailing Address - Fax:904-733-3304
Practice Address - Street 1:8081 PHILIPS HWY
Practice Address - Street 2:SUITE 9
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-7464
Practice Address - Country:US
Practice Address - Phone:904-739-2050
Practice Address - Fax:904-733-3304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 2648152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU99831Medicare UPIN
FLK5724Medicare ID - Type Unspecified
FL5100530001Medicare NSC