Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME86978 | FL |
N | 111NI0900X | Internist | ME86978 | FL |
N | 207RC0000X | Internist - Cardiovascular Disease | ME86978 | FL |
Y | 207RI0011X | Interventional Cardiology | ME86978 | FL |
NPI | 1114021144 |
---|---|
Provider Name | Dr. Steven Bradshaw Shoemaker |
First Address | Orlando, FL 32886-3407 |
Second Address | North Venice, FL 34275-3226 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2006 |
Last Update Date | 01/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2784831-00 | (05) | FL |
393799458A | (05) | GA |