MEDICARE: MR. SHAWN M. RONEY ATC, CSCS

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	2255A2300X	Athletic Trainer	AL1102	FL

General Provider Information

NPI Number	:	1427042555
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SHAWN M. RONEY ATC, CSCS

Provider Business Mailing Address
First Line	:	8161 ANDOVER CT
Second Line	:	B
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-8425
Country	:	US
Telephone Number	:	561-512-6466
Fax Number	:

Provider Business Practice Location Address
First Line	:	6901 PARKER AVE
Second Line	:	ATHLETIC TRAINER - SHAWN RONEY
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33405-4555
Country	:	US
Telephone Number	:	561-540-2454
Fax Number	:

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

Provider Enumeration Date	:	09/05/2005
Last Update Date	:	07/08/2007

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