Individual
SHAWN STAFFORD CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3402 W DR MARTIN LUTHER KING JR BLVD, TAMPA, FL 33607-6214
(813) 875-3950
(813) 872-2741
Mailing address
PO BOX 102222, ATLANTA, GA 30368-2222
(239) 274-8200
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
2009-0003
NC
207U00000X
Nuclear Medicine Physician
Primary
ME119355
FL
2085R0202X
Diagnostic Radiology Physician
ME119355
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017514000
—
FL
01
—
ITM0X
FLORIDA BCBS
FL
01
—
OU964
HF MEDICARE
FL
Enumeration date
05/25/2007
Last updated
04/26/2026
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