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General NPI Number Information
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NPI Number | 1548360423
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Entity Type | Individual
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Provider Name | ANTHONY L. PEARSON-SHAVER MD
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Gender | Male
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 13001 SOUTHERN BLVD
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City | LOXAHATCHEE
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State | FL
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Zip | 33470-9203
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Country | US
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Telephone | 561-798-6092
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Fax | 561-753-4241
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Provider Business Mailing Address
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Address Line | 13001 SOUTHERN BLVD
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City | LOXAHATCHEE
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State | FL
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Zip | 33470-9203
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Country | US
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Telephone | 561-798-6092
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Fax |
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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 | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number | 028857
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License Number State | GA
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