Provider Demographics
NPI:1003983123
Name:MERRITT, SHEILA D (OD)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:D
Last Name:MERRITT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:SHEILA
Other - Middle Name:D
Other - Last Name:MERRITT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD,PA
Mailing Address - Street 1:1069 MEADOW VIEW LN
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32092-1055
Mailing Address - Country:US
Mailing Address - Phone:904-268-2299
Mailing Address - Fax:
Practice Address - Street 1:9760 SAN JOSE BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-5474
Practice Address - Country:US
Practice Address - Phone:904-268-2299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC2632152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist