Healthcare Provider Details

I. General information

NPI: 1154401115
Provider Name (Legal Business Name): SHEILA MCLEOD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHEILA THOMAS M.D.

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 02/04/2020
Certification Date: 02/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 N HIGHWAY A1A STE 147
INDIALANTIC FL
32903-2858
US

IV. Provider business mailing address

3300 S FISKE BLVD
ROCKLEDGE FL
32955-4306
US

V. Phone/Fax

Practice location:
  • Phone: 321-951-9087
  • Fax: 321-952-9048
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME0074640
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: