Provider Demographics
NPI:1952593527
Name:FALDEN, DAVID (OD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:FALDEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14964 MAX LEGGETT PKWY
Mailing Address - Street 2:STE 106
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218-7270
Mailing Address - Country:US
Mailing Address - Phone:904-724-7707
Mailing Address - Fax:904-720-0471
Practice Address - Street 1:14964 MAX LEGGETT PKWY STE 106
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-7270
Practice Address - Country:US
Practice Address - Phone:904-686-1386
Practice Address - Fax:904-686-1363
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-16
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 4219152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist