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Organization

JUSTIN L. SHIELDS MD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JUSTIN L SHIELDS M.D. (PRESIDENT)
(850) 380-0481
Entity
Organization

Contact information

Practice address
540 FONTAINE ST, PENSACOLA, FL 32503-2019
(850) 484-4775
(850) 484-8223
Mailing address
PO BOX 1555, GULF BREEZE, FL 32562-1555
(850) 484-4775
(850) 484-8223

Taxonomy

Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
ME45060
FL

Other

Enumeration date
07/11/2006
Last updated
08/22/2020
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