Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | ME111949 | FL |
NPI | 1174785935 |
---|---|
Provider Name | Dr. Lindsay Nicole Shroyer |
First Address | Venice, FL 34285-2425 |
Second Address | Venice, FL 34285 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2008 |
Last Update Date | 01/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
33181 | BCBS FLORIDA (01) | FL |