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General NPI Number Information
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NPI Number | 1265614465
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Entity Type | Organization
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Legal Business Name | SHIRLEY & ASSOCIATES CHARTERED INC.
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Dates
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Enumeration Date | 11/29/2007
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Last Update Date | 11/29/2007
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Provider Practice Location Address
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Address Line | 3728 PHILLIPS HWY SUITE 214A
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City | JACKSONVILLE
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State | FL
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Zip | 32207-9300
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Country | US
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Telephone | 904-398-2010
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Fax | 904-398-7154
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Provider Business Mailing Address
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Address Line | 3728 PHILLIPS HWY SUITE 214A
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City | JACKSONVILLE
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State | FL
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Zip | 32207-9300
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Country | US
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Telephone | 904-398-2010
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Fax | 904-398-7154
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAUL D SHIRLEY
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Credential | M.D.
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Telephone | 904-398-2010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | ME21555
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License Number State | FL
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