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Individual
FREDERICK BRETT SHANNON
Active
Individual
FREDERICK BRETT SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
OS4993
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16065
STAYWELL HEALTHY KIDS
FL
01
—
195066
AMERIGROUP
FL
01
—
2017372-007
CIGNA
FL
01
—
207270
AVMED
FL
05
—
372036500
—
FL
01
—
4283415
AETNA
FL
01
—
80729
BLUE CROSS BLUE SHIELD
FL
Enumeration date
07/28/2006
Last updated
03/06/2018
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