Healthcare Provider Details

I. General information

NPI: 1518010248
Provider Name (Legal Business Name): MICHELE SHRINER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 05/25/2021
Certification Date: 05/25/2021
Deactivation Date: 01/06/2015
Reactivation Date: 05/25/2021

III. Provider practice location address

225 SW 7TH TERRACE
GAINESVILLE FL
32601
US

IV. Provider business mailing address

225 SW 7TH TERRACE
GAINESVILLE FL
32601
US

V. Phone/Fax

Practice location:
  • Phone: 352-379-2829
  • Fax: 352-379-2843
Mailing address:
  • Phone: 352-379-2829
  • Fax: 352-379-2843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPY6200
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberFLPY6200
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: