Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | P00002216 | FL |
Y | 222Z00000X | Podiatrist | P00002216 | FL |
NPI | 1053308924 |
---|---|
Provider Name | Paul L Sheehy Jr |
First Address | Tampa, FL 33673-7756 |
Second Address | Tampa, FL 33603-3338 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2005 |
Last Update Date | 19/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
056645400 | (05) | FL |
T92640 | (02) |