Healthcare Provider Details

I. General information

NPI: 1194643205
Provider Name (Legal Business Name): JOHN GERALD SHAFFER III DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1919 E HIGHWAY 50
CLERMONT FL
34711-1975
US

IV. Provider business mailing address

15820 THOROUGHBRED LN
MONTVERDE FL
34756-3333
US

V. Phone/Fax

Practice location:
  • Phone: 407-612-0109
  • Fax:
Mailing address:
  • Phone: 407-694-7885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTT44881
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: