Basic Information
Provider Information
NPI: 1326444340
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHEID
FirstName: LAURIE
MiddleName: LYNN
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7855 ARGYLE FOREST BLVD STE 101
Address2:  
City: JACKSONVILLE
State: FL
PostalCode: 322445597
CountryCode: US
TelephoneNumber: 9042826331
FaxNumber: 9042824117
Practice Location
Address1: 7855 ARGYLE FOREST BLVD STE 601
Address2:  
City: JACKSONVILLE
State: FL
PostalCode: 32244
CountryCode: US
TelephoneNumber: 9047783389
FaxNumber: 9047783395
Other Information
ProviderEnumerationDate: 11/18/2014
LastUpdateDate: 07/13/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XARNP9458046FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

ID Information
IDTypeStateIssuerDescription
02466440005FL MEDICAID


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