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General NPI Number Information
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NPI Number | 1730697327
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Entity Type | Organization
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Legal Business Name | SHELTON MEDICAL SERVICES,INC
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Dates
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Enumeration Date | 01/17/2018
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Last Update Date | 07/07/2020
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Provider Practice Location Address
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Address Line | 3525 NW 7TH ST
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City | MIAMI
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State | FL
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Zip | 33125-4015
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Country | US
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Telephone | 786-801-0218
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Fax | 786-353-9125
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Provider Business Mailing Address
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Address Line | 3525 NW 7TH ST
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City | MIAMI
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State | FL
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Zip | 33125-4015
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Country | US
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Telephone | 786-801-0218
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Fax | 786-353-9125
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Authorized Official
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Title or Position | PRESIDENT
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Name | GRETELL KAMANEL
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Credential |
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Telephone | 786-801-0218
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | HCC10414
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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