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Organization
SHAW MEDICAL GROUP LLC
Active
Organization
SHAW MEDICAL GROUP LLC
Active
Other names
MyHealth by Shaw Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARMENCITA E SHAW DNP (PROVIDER)
(321) 593-6999
Entity
Organization
Contact information
Practice address
947 BAREFOOT BLVD, BAREFOOT BAY, FL 32976-7101
(321) 593-6999
(321) 327-2262
Mailing address
947 BAREFOOT BLVD, BAREFOOT BAY, FL 32976-7101
(321) 593-6999
(321) 327-2262
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019879900
—
FL
05
—
019884700
—
FL
Enumeration date
07/28/2016
Last updated
05/25/2023
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