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NPI Code Detail

MEDICARE: JAMES K SHEA M.D.

MEDICARE: JAMES K SHEA M.D.
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation PhysicianME45929FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ME45929OTHERFLFLORIDA MEDICAL LICENSE

General Provider Information

NPI Number : 1144385287
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES K SHEA M.D.
Provider Business Mailing Address
First Line : PO BOX 547729
Second Line :
City : ORLANDO
State : FL
Zip : 32854-7729
Country : US
Telephone Number : 321-279-5586
Fax Number : 407-843-5040
Provider Business Practice Location Address
First Line : 16890 US HIGHWAY 441
Second Line :
City : MOUNT DORA
State : FL
Zip : 32757-6705
Country : US
Telephone Number : 352-385-4404
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/27/2006
Last Update Date : 01/11/2024

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