Individual
SHANNON DORER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
2 TAMPA GENERAL CIR, TAMPA, FL 33606-3571
(813) 821-8038
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 821-8038
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
SP028634
PA
363LA2100X
Acute Care Nurse Practitioner
SP028634
PA
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN11040091
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128109700
—
FL
01
—
FBHBK
BCBS
FL
Enumeration date
11/13/2023
Last updated
11/17/2025
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