Individual
MATTHEW M MERRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
545 HEALTH BLVD, DAYTONA BEACH, FL 32114-1493
(386) 239-8500
Mailing address
12109 COUNTY ROAD 103, OXFORD, FL 34484-2951
(352) 205-8981
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME80554
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35978
BLUE SHIELD
—
Enumeration date
05/15/2006
Last updated
12/17/2020
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