Individual
SHASHIKALA DWIVEDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1401 CENTERVILLE RD, SUITE300, TALLAHASSEE, FL 32308
(850) 558-1233
(850) 201-2544
Mailing address
3774 SW 60TH TER, DAVIE, FL 33314-2530
(954) 288-9839
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9106431
FL
Other
Enumeration date
02/16/2012
Last updated
02/06/2014
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