# BRUCE D SHEPHARD MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326001868
- **Authorized official:** MR. BRUCE D SHEPHARD MD (PRESIDENT)
- **Authorized official phone:** (813) 928-5276

## Contact information

- **Practice address:** 13014 N DALE MABRY HWY, \#208, TAMPA, FL 33618-2808
- **Practice address phone:** (813) 928-5276
- **Mailing address:** 13014 N DALE MABRY HWY, \#208, TAMPA, FL 33618-2808
- **Mailing address phone:** (813) 928-5276

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 24560 | FL | Yes |

## Other

- **Enumeration date:** 04/07/2006
- **Last updated:** 07/06/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 374753100 | — | FL |