MEDICARE: SHAYLA NICOLE MYERS DPT

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
1	163WR0400X	Rehabilitation Registered Nurse	1171203	TX

General Provider Information

NPI Number	:	1255665378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAYLA NICOLE MYERS DPT

Provider Business Mailing Address
First Line	:	133 STONEBRIDGE ST
Second Line	:
City	:	BURKBURNETT
State	:	TX
Zip	:	76354-2242
Country	:	US
Telephone Number	:	904-687-9022
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 N WESTSHORE BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-1140
Country	:	US
Telephone Number	:	813-371-3410
Fax Number	:

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

Provider Enumeration Date	:	09/22/2009
Last Update Date	:	09/22/2009

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