MEDICARE: SHANNON FERNANDEZ-LEDON

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	208000000X	Pediatrics Physician	1026483	MA

General Provider Information

NPI Number	:	1568164424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNON FERNANDEZ-LEDON

Provider Business Mailing Address
First Line	:	637 WASHINGTON ST STE 202
Second Line	:
City	:	BROOKLINE
State	:	MA
Zip	:	02446-4579
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	637 WASHINGTON ST STE 202
Second Line	:
City	:	BROOKLINE
State	:	MA
Zip	:	02446-4579
Country	:	US
Telephone Number	:	617-232-2811
Fax Number	:

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

Provider Enumeration Date	:	03/21/2023
Last Update Date	:	03/09/2026

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Directions to “ SHANNON FERNANDEZ-LEDON ” Practice Location

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