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Individual

SHANA CAMILLE KIRBY FLORVELLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3515 E FLETCHER AVE # MDC14, TAMPA, FL 33613-4702
(813) 974-8900
(813) 974-1131
Mailing address
PO BOX 917770, ORLANDO, FL 32891-7770
(813) 974-2201

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
4301098952
MI
2084P0800X
Psychiatry Physician
Primary
ME119309
FL
2084P0804X
Child & Adolescent Psychiatry Physician
ME 119309
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
017931400
FL
01
X345L
BLUE CROSS BLUE SHIELD FLORIDA
FL
Enumeration date
07/29/2011
Last updated
01/05/2018
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