MEDICARE: DR. STEVEN BRADSHAW SHOEMAKER M.D.

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME86978	FL
2	207RC0000X	Cardiovascular Disease Physician	ME86978	FL
3	207RI0011X	Interventional Cardiology Physician	ME86978	FL

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1114021144
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN BRADSHAW SHOEMAKER M.D.

Provider Business Mailing Address
First Line	:	PO BOX 863407
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32886-3407
Country	:	US
Telephone Number	:	941-917-2600
Fax Number	:	941-917-7884

Provider Business Practice Location Address
First Line	:	200 HEALTHCARE WAY
Second Line	:	SUITE 103
City	:	NORTH VENICE
State	:	FL
Zip	:	34275-3226
Country	:	US
Telephone Number	:	941-261-0160
Fax Number	:	941-261-0165

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/11/2006
Last Update Date	:	10/01/2021

200 HEALTHCARE WAY , SUITE 202
NORTH VENICE, FL
34275-3226

Practice Phone: 941-261-0160
Practice Fax: 941-261-0165