Healthcare Provider Details

I. General information

NPI: 1073376000
Provider Name (Legal Business Name): SHELBY MYERS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2024
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 NW 13TH ST FL 1
BOCA RATON FL
33486-2305
US

IV. Provider business mailing address

701 NW 13TH ST FL 1
BOCA RATON FL
33486-2305
US

V. Phone/Fax

Practice location:
  • Phone: 561-955-4111
  • Fax:
Mailing address:
  • Phone: 561-955-4111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0203X
TaxonomyRadiation Oncology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: