Individual
DR. STANLEY H SHROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4729 US HIGHWAY 98 S, LAKELAND, FL 33812-4323
(863) 646-5789
(863) 646-5834
Mailing address
PO BOX 10744, CLEARWATER, FL 33757
(727) 532-0002
(727) 266-4943
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME103638
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000891800
—
FL
01
—
29218
BLUE CROSS BLUE SHIELD
FL
01
—
P00723081
RAILROAD MEDICARE
FL
Enumeration date
06/17/2006
Last updated
06/02/2017
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