Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | OPC 4565 | FL |
NPI | 1003122276 |
---|---|
Provider Name | Dr. Melisa Shannon Hockett |
First Address | Orlando, FL 32803-3819 |
Second Address | Orlando, FL 32803-3819 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2010 |
Last Update Date | 26/08/2010 |