Organization
SAND DOLLAR PSYCHIATRIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. REBECCA L SHELTON (OFFICE MANAGER)
(850) 226-7100
Entity
Organization
Contact information
Practice address
137 CRYSTAL BEACH DR STE 137-C, DESTIN, FL 32541-3569
(850) 226-7100
Mailing address
PO BOX 1648, DESTIN, FL 32540-1648
(850) 226-7100
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57629
BCBS FL
FL
Enumeration date
10/12/2006
Last updated
12/31/2018
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