Healthcare Provider Details

I. General information

NPI: 1255576906
Provider Name (Legal Business Name): MERITT AND ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2008
Last Update Date: 12/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 W 8TH ST
JACKSONVILLE FL
32206-4332
US

IV. Provider business mailing address

431 W 8TH ST
JACKSONVILLE FL
32206-4332
US

V. Phone/Fax

Practice location:
  • Phone: 904-355-1553
  • Fax: 904-356-7774
Mailing address:
  • Phone: 904-355-1553
  • Fax: 904-356-7774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO865
License Number StateFL

VIII. Authorized Official

Name: DR. STEPHEN M MERITT
Title or Position: OWNER
Credential: DPM
Phone: 904-355-1553