Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 70910 | GA |
N | 208600000X | Surgeon | 70910 | GA |
N | 2086S0129X | Vascular Surgeon | 70910 | GA |
Y | 2086S0129X | Vascular Surgeon | ME104191 | FL |
NPI | 1154570851 |
---|---|
Provider Name | Dr. Susan M Shafii |
First Address | Clearwater, FL 33757-8744 |
Second Address | Clearwater, FL 33756-3369 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2008 |
Last Update Date | 08/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
023815000 | (05) | FL |