Healthcare Provider Details

I. General information

NPI: 1174613954
Provider Name (Legal Business Name): GAIL SHAFRAN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GAIL KATZ FNP

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 05/04/2022
Certification Date: 05/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4216 CORTEZ RD W
BRADENTON FL
34210-3121
US

IV. Provider business mailing address

4216 CORTEZ RD W
BRADENTON FL
34210-3121
US

V. Phone/Fax

Practice location:
  • Phone: 941-500-3100
  • Fax:
Mailing address:
  • Phone: 941-500-5113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11017946
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: