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General NPI Number Information
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NPI Number | 1083664874
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Entity Type | Individual
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Provider Name | CARL TYLER SHENKMAN M.D., J.D., LLM
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Gender | Male
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 501 S LINCOLN AVE STE 22
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City | CLEARWATER
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State | FL
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Zip | 33756-5964
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Country | US
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Telephone | 727-357-7828
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Fax | 727-337-7646
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Provider Business Mailing Address
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Address Line | 501 S LINCOLN AVE STE 22
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City | CLEARWATER
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State | FL
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Zip | 33756-5964
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Country | US
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Telephone | 727-357-7828
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Fax | 727-337-7646
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 036000
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 36000
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | ME118247
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | ME118247
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License Number State | FL
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