Provider Demographics
NPI:1386887164
Name:DR PAUL J CONE EYE PA
Entity type:Organization
Organization Name:DR PAUL J CONE EYE PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:J
Authorized Official - Last Name:CONE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:904-743-1311
Mailing Address - Street 1:961 CESERY BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32211-5607
Mailing Address - Country:US
Mailing Address - Phone:904-743-1311
Mailing Address - Fax:904-743-2802
Practice Address - Street 1:961 CESERY BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32211-5607
Practice Address - Country:US
Practice Address - Phone:904-743-1311
Practice Address - Fax:904-743-2802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-09
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 912332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6150830001Medicare NSC