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General NPI Number Information
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NPI Number | 1972690329
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Entity Type | Individual
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Provider Name | ALISSA MARIE SHULMAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 10/18/2012
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Provider Practice Location Address
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Address Line | 1950 ARLINGTON ST SUITE 112
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City | SARASOTA
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State | FL
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Zip | 34239-3507
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Country | US
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Telephone | 941-366-5476
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Fax | 941-866-7388
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Provider Business Mailing Address
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Address Line | 1950 ARLINGTON STREET SUITE 112
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City | SARASOTA
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State | FL
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Zip | 34239-3508
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Country | US
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Telephone | 941-366-5476
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Fax | 941-866-7388
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | ME103128
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License Number State | FL
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