Individual
JULIE SHANER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 265-0301
Mailing address
PO BOX 100286, GAINESVILLE, FL 32610-0286
(352) 265-0535
(352) 627-4173
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME145875
FL
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
MD464339
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106629200
—
FL
Enumeration date
04/07/2012
Last updated
11/05/2025
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