MEDICARE: DR. ANTHONY ANDREW SHYDOHUB MD

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	2084N0400X	Neurology Physician	ME0061680	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	:	1275569899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTHONY ANDREW SHYDOHUB MD

Provider Business Mailing Address
First Line	:	5441 N UNIVERSITY DR STE 101
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-4640
Country	:	US
Telephone Number	:	954-803-9002
Fax Number	:	954-688-9118

Provider Business Practice Location Address
First Line	:	5441 N UNIVERSITY DR STE 101
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-4640
Country	:	US
Telephone Number	:	954-803-9002
Fax Number	:	954-933-2305

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

Provider Enumeration Date	:	06/24/2006
Last Update Date	:	02/17/2023

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