Marilyn Marie Wilson

Primary specialty

OpticianTaxonomy code 156FX1800X

License

DO4862 Issued in FL

Practice address

14500 US Highway 301 S
Starke, FL 32091-7858

Phone

(904) 964-2250

Fax

(904) 964-2425

NPI assigned

Aug 11, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1691712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1598448938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 THOMAS LN",
            "city": "HAMPTON",
            "state": "FL",
            "postal_code": "320444466",
            "telephone_number": "904-964-2250",
            "fax_number": "904-964-2425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14500 US HIGHWAY 301 S",
            "city": "STARKE",
            "state": "FL",
            "postal_code": "320917858",
            "telephone_number": "904-964-2250",
            "fax_number": "904-964-2425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MARILYN",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-11",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "FL",
            "license": "DO4862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dean Stanton White, M.D.
• April Lynn Whitney, HIS
• Jaqueisha R Williams, PHARMD
• Marcia Williams, APRN
• Tammy Jean Williams, ARNP
• Windsor Center Operations LLC
• Womens Health of North Central Florida, PLLC
• Amber Brittany Wouda, LAT, ATC
• Wendy A Wright, LMT
• Jeremiah Yoder

• Optician in Starke, FL
• Providers in Starke, FL by specialty
• Optician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.