MEDICARE: MICHELLE SHULA 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	363AM0700X	Medical Physician Assistant	PA9106956	FL

General Provider Information

NPI Number	:	1447595665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE SHULA PA-C

Provider Business Mailing Address
First Line	:	1166 W NEWPORT CENTER DR
Second Line	:	SUITE 100
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33442-7739
Country	:	US
Telephone Number	:	954-782-7701
Fax Number	:

Provider Business Practice Location Address
First Line	:	1166 W NEWPORT CENTER DR
Second Line	:	SUITE 100
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33442-7739
Country	:	US
Telephone Number	:	954-782-7701
Fax Number	:

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

Provider Enumeration Date	:	11/28/2012
Last Update Date	:	02/05/2018

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Directions to “ MICHELLE SHULA PA-C” Practice Location

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