Provider Demographics
NPI:1831539105
Name:BOESKOOL, ZACHARY (OD)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:BOESKOOL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11407
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35246-8575
Mailing Address - Country:US
Mailing Address - Phone:864-359-1308
Mailing Address - Fax:
Practice Address - Street 1:3 SHIRCLIFF WAY STE 134
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-4785
Practice Address - Country:US
Practice Address - Phone:904-296-0098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-01
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004774152W00000X
GAOPT003146152W00000X
FLOPC6627152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist