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Individual
DR. SHERRIE D TEDDY
Active
Individual
DR. SHERRIE D TEDDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ODPA
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC1797
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0482470001
PALMETTO GBA/ DMERC
FL
01
—
117635
EYEMED PROVIDER NUMBER
FL
01
—
19293
B.C. B.S. ID NUMBER
FL
01
—
19293Z
MEDICARE PTAN
FL
01
—
410031537
MEDICARE RR
FL
01
—
OPC1797
FL LICENSE
FL
Enumeration date
09/14/2005
Last updated
10/07/2011
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