MEDICARE: MR. SHAWN HUFFMAN

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	237700000X	Hearing Instrument Specialist	AS5115	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407222193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SHAWN HUFFMAN

Provider Business Mailing Address
First Line	:	2751 ENTERPRISE RD
Second Line	:	SUITE 106
City	:	ORANGE CITY
State	:	FL
Zip	:	32763-8256
Country	:	US
Telephone Number	:	386-775-0220
Fax Number	:	386-775-0221

Provider Business Practice Location Address
First Line	:	2751 ENTERPRISE RD
Second Line	:	SUITE 106
City	:	ORANGE CITY
State	:	FL
Zip	:	32763-8256
Country	:	US
Telephone Number	:	386-775-0220
Fax Number	:	386-775-0221

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

Provider Enumeration Date	:	08/17/2015
Last Update Date	:	08/18/2015

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Directions to “ MR. SHAWN HUFFMAN ” Practice Location

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