Individual
SHANNON MIXON COVITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
18167 US HIGHWAY 19 N, SUITE 650, CLEARWATER, FL 33764-3528
(800) 507-8874
Mailing address
21 BELLEVUE DR, TREASURE ISLAND, FL 33706-1201
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS 11652
FL
Other
Enumeration date
06/30/2008
Last updated
03/28/2013
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