Healthcare Provider Details

I. General information

NPI: 1144687500
Provider Name (Legal Business Name): NATALIE SHIFF MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2016
Last Update Date: 03/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD PEDIATRICS IMMUNOLOGY/RHEUMATOLOGY
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

1600 SW ARCHER RD PEDIATRICS IMMUNOLOGY/RHEUMATOLOGY PO BOX 100296
GAINESVILLE FL
32610-3003
US

V. Phone/Fax

Practice location:
  • Phone: 352-294-8323
  • Fax:
Mailing address:
  • Phone: 352-294-8323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0216X
TaxonomyPediatric Rheumatology Physician
License Number1750
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: