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1356830632

NPI Code Detail

MEDICARE: MR. SHION ANTONIO BETTY MD

MEDICARE: MR. SHION ANTONIO BETTY 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	207R00000X	Internal Medicine Physician	ME177697	FL
2	208M00000X	Hospitalist Physician	ME177697	FL
3	207R00000X	Internal Medicine Physician	MD474627	PA
4	208M00000X	Hospitalist Physician	MD474627	PA

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	:	1356830632
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SHION ANTONIO BETTY MD

Provider Business Mailing Address
First Line	:	PO BOX 2147
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33902-2147
Country	:	US
Telephone Number	:	239-424-2602
Fax Number	:	239-343-1009

Provider Business Practice Location Address
First Line	:	13681 DOCTORS WAY
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33912-4300
Country	:	US
Telephone Number	:	239-424-2602
Fax Number	:	239-343-1009

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

Provider Enumeration Date	:	05/02/2018
Last Update Date	:	03/06/2026

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Directions to “ MR. SHION ANTONIO BETTY MD” Practice Location

Language	Start Address	Practice Location

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