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NPI Code Detail

MEDICARE: SHELBY DENISE MCCORMICK

MEDICARE: SHELBY DENISE MCCORMICK
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
1122300000XDentistDN30962FL

General Provider Information

NPI Number : 1922708247
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELBY DENISE MCCORMICK
Provider Business Mailing Address
First Line : 12427 HIGHWAY 231
Second Line :
City : YOUNGSTOWN
State : FL
Zip : 32466-2562
Country : US
Telephone Number : 860-539-0681
Fax Number :
Provider Business Practice Location Address
First Line : 12427 HIGHWAY 231
Second Line :
City : YOUNGSTOWN
State : FL
Zip : 32466-2562
Country : US
Telephone Number : 850-753-3246
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2023
Last Update Date : 09/30/2025

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Directions to “ SHELBY DENISE MCCORMICK ” Practice Location

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