MEDICARE: SHANNON FLOYD DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	PO 3406	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235463001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNON FLOYD DPM

Provider Business Mailing Address
First Line	:	4900 SW 46TH CT
Second Line	:	2108
City	:	OCALA
State	:	FL
Zip	:	34474-6264
Country	:	US
Telephone Number	:	352-354-3730
Fax Number	:	352-509-7340

Provider Business Practice Location Address
First Line	:	11834 COUNTY ROAD 101
Second Line	:	SUITE 203
City	:	LADY LAKE
State	:	FL
Zip	:	32162-9340
Country	:	US
Telephone Number	:	352-633-8230
Fax Number	:	352-633-8232

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2009
Last Update Date	:	02/20/2013

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Directions to “ SHANNON FLOYD DPM” Practice Location

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