Healthcare Provider Details

I. General information

NPI: 1164583654
Provider Name (Legal Business Name): JEFFREY NEIL SHEBOVSKY DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11364 S ORANGE BLOSSOM TRL
ORLANDO FL
32837-9426
US

IV. Provider business mailing address

11364 S ORANGE BLOSSOM TRL
ORLANDO FL
32837-9426
US

V. Phone/Fax

Practice location:
  • Phone: 407-857-6166
  • Fax: 407-857-0122
Mailing address:
  • Phone: 407-857-6166
  • Fax: 407-857-0122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberCH6499
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: