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NPI Code Detail

MEDICARE: SHELLEY BRACE M.D.

MEDICARE: SHELLEY BRACE M.D.
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
12084P0800XPsychiatry PhysicianME73719FL

Other Identifiers

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

General Provider Information

NPI Number : 1811042526
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELLEY BRACE M.D.
Provider Business Mailing Address
First Line : 1565 STATE ST
Second Line :
City : SARASOTA
State : FL
Zip : 34236-5808
Country : US
Telephone Number : 941-927-8900
Fax Number :
Provider Business Practice Location Address
First Line : 1565 STATE ST
Second Line :
City : SARASOTA
State : FL
Zip : 34236-5808
Country : US
Telephone Number : 941-927-8900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2007
Last Update Date : 02/28/2017

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