Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | ME 53437 | FL |
NPI | 1720185465 |
---|---|
Provider Name | Dr. Robert Shefsky |
First Address | Bradenton, FL 34203-4057 |
Second Address | St Petersburg, FL 33705-1400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2006 |
Last Update Date | 08/07/2007 |