Healthcare Provider Details

I. General information

NPI: 1093397705
Provider Name (Legal Business Name): MICHAEL ROCKLIN SHUMAKER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2021
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8950 N KENDALL DR STE 504W
MIAMI FL
33176-2127
US

IV. Provider business mailing address

15685 SW 127TH AVE APT 504
MIAMI FL
33177-1521
US

V. Phone/Fax

Practice location:
  • Phone: 305-274-2030
  • Fax:
Mailing address:
  • Phone: 423-667-2953
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: