HERMAN M. DUPERAULT, JR., O.D., P.A.
Managed Care Organizations at Atlantic Blvd, Jacksonville, FL

License number
Florida OPC 672
Category
Managed Care Organizations
Type
Point of Service
Owner
Name: DR. HERMAN M DUPERAULT JR. O.D.
Title: PRESIDENT
Phone: (904) 246-0404
Address
Address
447 Atlantic Blvd SUITE 1, Jacksonville, FL 32233
National Provider ID: 1710900824
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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Herman M. Duperault, Jr., O.D., PA

Jacksonville, FL

Status:
Inactive
Industry:
Optometrist's Office
Registration:
Apr 6, 1989
Addresses:
447 Atlantic Blvd, Jacksonville, FL 32233
326 Broad St, Jacksonville, FL 32202
3078 Merrill Blvd, Jacksonville, FL 32250
State ID:
K78086
Business type:
Domestic for Profit Corporation
Chairman, President, Treasurer, Secretary, Vice President:
Herman M. Duperault Chairman, President, Treasurer, Secretary, Vice President, inactive

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