Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OPC2265 | FL |
NPI | 1013029578 |
---|---|
Provider Name | Melanie J Carvell |
First Address | Jacksonville, FL 32244-5801 |
Second Address | Jacksonville, FL 32244-5801 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 18/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
19178 | BLUE CROSS BLUE SHIELD (01) | |
33476000 | DAVISVISION (01) | |
591515138 | AETNA (01) | |
591515138 | CIGNA (01) | |
591515138 | COMP BENEFITS (01) | |
591515138 | TRICARE (01) | |
591515138 | VISION SERVICE PLAN (01) | |
U09670 | (02) |