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NPI Code Detail

MEDICARE: MICHAEL N. SHEVACH MD

MEDICARE: MICHAEL N. SHEVACH MD
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
12085R0001XRadiation Oncology PhysicianME0051343FL

General Provider Information

NPI Number : 1194710285
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL N. SHEVACH MD
Provider Business Mailing Address
First Line : 1324 LAKELAND HILLS BLVD
Second Line : ATTN: MEDICAL STAFF OFFICE
City : LAKELAND
State : FL
Zip : 33805-4543
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3525 LAKELAND HILLS BLVD
Second Line :
City : LAKELAND
State : FL
Zip : 33805-1965
Country : US
Telephone Number : 863-603-6565
Fax Number : 863-904-1961
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2005
Last Update Date : 07/26/2022

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Directions to “ MICHAEL N. SHEVACH MD” Practice Location

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