Individual
DMITRIY SHISHKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
311 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-2781
(386) 255-2340
Mailing address
PO BOX 100265, GAINESVILLE, FL 32610-0265
(352) 273-9000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN9288346
FL
363LA2200X
Adult Health Nurse Practitioner
9288346
FL
Other
Enumeration date
12/20/2016
Last updated
10/24/2022
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