Healthcare Provider Details

I. General information

NPI: 1598244477
Provider Name (Legal Business Name): SHIRLEY MCGEE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2018
Last Update Date: 08/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2456 ATRIUM CIR
ORLANDO FL
32808-4410
US

IV. Provider business mailing address

2456 ATRIUM CIR
ORLANDO FL
32808-4410
US

V. Phone/Fax

Practice location:
  • Phone: 321-292-0917
  • Fax: 407-293-1028
Mailing address:
  • Phone: 321-292-0917
  • Fax: 407-293-1028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: