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Individual

DR. SHEA SPEIGHTS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ED. D

Contact information

Practice address
103 W HAMILTON AVE, TAMPA, FL 33604-5420
(813) 650-7720
Mailing address
1503 WARMAN CT, TAMPA, FL 33613-1527
(813) 650-7720
(813) 354-2534

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
692610096
FL
05
692610098
FL
Enumeration date
10/11/2012
Last updated
10/11/2012
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