MEDICARE: SHIRLEY HERR PA-C

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	363A00000X	Physician Assistant	PA9116311	FL
2	363A00000X	Physician Assistant	MA063265	PA

General Provider Information

NPI Number	:	1285391359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHIRLEY HERR PA-C

Provider Business Mailing Address
First Line	:	38135 MARKET SQUARE DR
Second Line	:
City	:	ZEPHYRHILLS
State	:	FL
Zip	:	33542-7505
Country	:	US
Telephone Number	:	352-567-0188
Fax Number	:	813-355-5101

Provider Business Practice Location Address
First Line	:	7760 CURLEY RD STE 103
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33545-9153
Country	:	US
Telephone Number	:	813-779-8194
Fax Number	:	813-355-5043

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

Provider Enumeration Date	:	11/23/2021
Last Update Date	:	02/02/2024

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Directions to “ SHIRLEY HERR PA-C” Practice Location

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