Provider Demographics
NPI:1164958930
Name:LIND, SKYLER SAMUEL (OD)
Entity Type:Individual
Prefix:DR
First Name:SKYLER
Middle Name:SAMUEL
Last Name:LIND
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 1:28 COCHISE CT
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-8997
Mailing Address - Country:US
Mailing Address - Phone:386-237-1205
Mailing Address - Fax:
Practice Address - Street 1:250 PALM COAST PKWY NE UNIT 605
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-8225
Practice Address - Country:US
Practice Address - Phone:386-446-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 5349152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist