Healthcare Provider Details

I. General information

NPI: 1740290956
Provider Name (Legal Business Name): JOSEPH A SHIRER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 W COLONIAL DR SUITE 481
OCOEE FL
34761-3498
US

IV. Provider business mailing address

10000 W COLONIAL DR SUITE 481
OCOEE FL
34761-3498
US

V. Phone/Fax

Practice location:
  • Phone: 407-521-3550
  • Fax: 407-521-3557
Mailing address:
  • Phone: 407-521-3550
  • Fax: 407-521-3557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberME0053557
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: