Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OPC2632 | FL |
NPI | 1003983123 |
---|---|
Provider Name | Dr. Sheila D Merritt |
First Address | St Augustine, FL 32092-1055 |
Second Address | Jacksonville, FL 32257-5474 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2006 |
Last Update Date | 25/04/2014 |