Healthcare Provider Details

I. General information

NPI: 1346247533
Provider Name (Legal Business Name): MELINDA G. SHOEMAKER D.P.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2005
Last Update Date: 10/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 NW 14TH ST STE 103
MIAMI FL
33125-1653
US

IV. Provider business mailing address

8200 NW 27 ST STE 108
DORAL FL
33122-1906
US

V. Phone/Fax

Practice location:
  • Phone: 305-326-3338
  • Fax: 305-326-3339
Mailing address:
  • Phone: 786-662-3893
  • Fax: 786-662-3899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO 2153
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: