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NPI Code Detail

MEDICARE: SHYLAH MARIE MOORE PARDO MD

MEDICARE: SHYLAH MARIE MOORE PARDO MD
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
1207RI0200XInfectious Disease PhysicianME141455FL
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1942627872
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHYLAH MARIE MOORE PARDO MD
Provider Business Mailing Address
First Line : 1625 VILLAGE CENTER DR APT 105
Second Line :
City : LAKELAND
State : FL
Zip : 33803-2868
Country : US
Telephone Number : 787-431-6777
Fax Number :
Provider Business Practice Location Address
First Line : 13515 LAKE TERRACE LN
Second Line :
City : TAMPA
State : FL
Zip : 33637-1003
Country : US
Telephone Number : 813-998-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2014
Last Update Date : 07/29/2019

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