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NPI Code Detail

MEDICARE: KATHY J SHUFFLEBARGER P.T.

MEDICARE: KATHY J SHUFFLEBARGER P.T.
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
1225100000XPhysical TherapistPT1944FL
2222Q00000XDevelopmental TherapistPT1944FL
32251P0200XPediatric Physical TherapistPT0001944FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21342502OTHERFLINDIVIDUAL CITRUS HEALTH
3PT1944OTHERFLFLORIDA PT LICENSE
4Y905LOTHERFLBCBS FL

General Provider Information

NPI Number : 1881707305
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHY J SHUFFLEBARGER P.T.
Provider Business Mailing Address
First Line : 1215 E ORANGE ST
Second Line :
City : LAKELAND
State : FL
Zip : 33801-5762
Country : US
Telephone Number : 863-802-3800
Fax Number : 863-802-0480
Provider Business Practice Location Address
First Line : 1215 E ORANGE ST
Second Line :
City : LAKELAND
State : FL
Zip : 33801-5762
Country : US
Telephone Number : 863-802-3800
Fax Number : 863-802-0480
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2006
Last Update Date : 01/13/2011

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