Individual
MR. MICHAEL SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
12550 NEW BRITTANY BLVD, FORT MYERS, FL 33907-3655
(239) 343-9180
(239) 343-9188
Mailing address
P.O. BOX 2147, CAPE CORAL, FL 33991-2038
(239) 424-1449
(239) 424-1421
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
ARNP9220477
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
768068600
—
FL
Enumeration date
08/08/2006
Last updated
12/31/2015
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