Individual
JODI A SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
13020 N TELECOM PKWY, TEMPLE TERRACE, FL 33637-0925
(813) 978-9700
(813) 972-5055
Mailing address
13020 N TELECOM PKWY, TEMPLE TERRACE, FL 33637-0925
(813) 978-9700
(813) 972-5055
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
ME 65437
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102779
AVMED
FL
01
—
2086672
CIGNA
FL
01
—
23814
BLUE CROSS/BLUE SHIELD
FL
01
—
250008404
RAILROAD MEDICARE
FL
05
—
374794800
—
FL
01
—
5993051
AETNA
FL
Enumeration date
07/01/2005
Last updated
02/17/2012
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