Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | CH6499 | FL |
NPI | 1164583654 |
---|---|
Provider Name | Jeffrey Neil Shebovsky |
First Address | Orlando, FL 32837-9426 |
Second Address | Orlando, FL 32837-9426 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U48306 | (02) | FL |