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NPI Code Detail

MEDICARE: SHANE M BURKE MD, MBA

MEDICARE: SHANE M BURKE MD, MBA
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
1207T00000XNeurological Surgery Physician078276CT
2207T00000XNeurological Surgery PhysicianME181601FL

General Provider Information

NPI Number : 1184075996
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANE M BURKE MD, MBA
Provider Business Mailing Address
First Line : 2300 E COUNTY ROAD 540A FL 2
Second Line :
City : LAKELAND
State : FL
Zip : 33813-3825
Country : US
Telephone Number : 321-841-7550
Fax Number : 321-841-8185
Provider Business Practice Location Address
First Line : 2300 E COUNTY ROAD 540A FL 2
Second Line :
City : LAKELAND
State : FL
Zip : 33813-3825
Country : US
Telephone Number : 321-841-7550
Fax Number : 321-841-8185
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2016
Last Update Date : 06/19/2026

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Directions to “ SHANE M BURKE MD, MBA” Practice Location

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