# FREDERICK BRETT SHANNON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1518971225
- **Gender:** Man
- **Credential:** D.O.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | OS4993 | FL | Yes |

## Other

- **Enumeration date:** 07/28/2006
- **Last updated:** 03/06/2018

## 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 |