Provider Demographics
NPI:1770625899
Name:POVEDA, FLORA CHEN (OD)
Entity type:Individual
Prefix:DR
First Name:FLORA
Middle Name:CHEN
Last Name:POVEDA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:FLORA
Other - Middle Name:
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:11111 SAN JOSE BLVD STE 44
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-7274
Mailing Address - Country:US
Mailing Address - Phone:904-292-3976
Mailing Address - Fax:904-292-5322
Practice Address - Street 1:11111 SAN JOSE BLVD STE 44
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-7274
Practice Address - Country:US
Practice Address - Phone:904-292-3976
Practice Address - Fax:904-292-5322
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC003643152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist