Individual
JEANNA SHEA EAGERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
5505 N ATLANTIC AVE STE 105, COCOA BEACH, FL 32931-5118
(321) 383-1332
(321) 783-0065
Mailing address
665 S APOLLO BLVD, MELBOURNE, FL 32901-1485
(321) 984-3200
(321) 984-2620
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC 4078
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36029
BCBS FL
FL
05
—
621237900
—
FL
Enumeration date
06/09/2006
Last updated
08/28/2023
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