Individual
DR. SHANAN LOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4203 BELFORT ROAD, SUITE 204, JACKSONVILLE, FL 32216-1463
(904) 296-5688
(904) 296-5699
Mailing address
4203 BELFORT ROAD, SUITE 204, JACKSONVILLE, FL 32216-1463
(904) 296-5688
(904) 296-5699
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME93888
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2732653-00
—
FL
05
—
788979252A
—
GA
Enumeration date
02/24/2006
Last updated
05/21/2014
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