Provider Demographics
NPI:1154553774
Name:STRICKLAND, ELIZABETH JOY (OD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:JOY
Last Name:STRICKLAND
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2858 MAHAN DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-5446
Mailing Address - Country:US
Mailing Address - Phone:850-216-2020
Mailing Address - Fax:
Practice Address - Street 1:2858 MAHAN DR
Practice Address - Street 2:SUITE 4
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5446
Practice Address - Country:US
Practice Address - Phone:850-216-2020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-15
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4490152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001646900Medicaid
GAOPT002712OtherGEORGIA LICENSE
FLOPC4490OtherFLORIDA LICENSE
FLOPC4490OtherFLORIDA LICENSE