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General NPI Number Information
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NPI Number | 1861406019
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Entity Type | Organization
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Legal Business Name | ROGER SHEA ,M.D. ,INC.
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 09/17/2020
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Provider Practice Location Address
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Address Line | 5432 BEE RIDGE RD STE #140
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City | SARASOTA
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State | FL
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Zip | 34233-1514
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Country | US
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Telephone | 941-371-2244
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Fax | 941-371-1144
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Provider Business Mailing Address
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Address Line | 5432 BEE RIDGE RD STE #140
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City | SARASOTA
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State | FL
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Zip | 34233-1514
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Country | US
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Telephone | 941-371-2244
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Fax | 941-371-1144
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROGER M SHEA
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Credential | MD
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Telephone | 941-371-2244
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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 | ME0065243
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License Number State | FL
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