Organization
BRUCE D SHEPHARD MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRUCE D SHEPHARD MD (PRESIDENT)
(813) 928-5276
Entity
Organization
Contact information
Practice address
13014 N DALE MABRY HWY, #208, TAMPA, FL 33618-2808
(813) 928-5276
Mailing address
13014 N DALE MABRY HWY, #208, TAMPA, FL 33618-2808
(813) 928-5276
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
24560
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
374753100
—
FL
Enumeration date
04/07/2006
Last updated
07/06/2016
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