Healthcare Provider Details
I. General information
NPI: 1598699910
Provider Name (Legal Business Name): MAGNOLIA BAY PEDIATRICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4304 WINDMILL POINTE DR
PLANT CITY FL
33567-3645
US
IV. Provider business mailing address
4304 WINDMILL POINTE DR
PLANT CITY FL
33567-3645
US
V. Phone/Fax
- Phone: 813-601-3982
- Fax:
- Phone: 813-601-3982
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTIAN
SHEFFIELD
Title or Position: APRN
Credential: APRN
Phone: 813-601-3982