# SHOEBOAT, INC.

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

## Provider details

- **NPI number:** 1659386043
- **Authorized official:** TAB J. HALBERG C.PED (OWNER/PRESIDENT)
- **Authorized official phone:** (239) 481-3404

## Contact information

- **Practice address:** 9131 COLLEGE PKWY STE 120, FORT MYERS, FL 33919-5818
- **Practice address phone:** (239) 481-3404
- **Practice address fax:** (239) 481-6254
- **Mailing address:** 9131 COLLEGE PKWY STE 120, FORT MYERS, FL 33919-5818
- **Mailing address phone:** (239) 481-3404
- **Mailing address fax:** (239) 481-6254

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | PED 97 | FL | Yes |

## Other

- **Enumeration date:** 07/31/2006
- **Last updated:** 04/20/2011