Provider Demographics
NPI:1972936839
Name:SHUART, WHITNEY ALLISON (OD)
Entity type:Individual
Prefix:DR
First Name:WHITNEY
Middle Name:ALLISON
Last Name:SHUART
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:ALLISON
Other - Last Name:MCCORY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:149 E THATCH PALM CIR
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-7165
Mailing Address - Country:US
Mailing Address - Phone:812-569-0516
Mailing Address - Fax:
Practice Address - Street 1:149 E THATCH PALM CIR
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7165
Practice Address - Country:US
Practice Address - Phone:812-569-0516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-14
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPT4803152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015053500Medicaid