Individual
DR. BRIAN MICHAEL SHAUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
14254 MARTIN LUTHER KING BLVD, DOVER, FL 33527-4414
(813) 349-7700
(813) 349-7761
Mailing address
13110 ELK MOUNTAIN DR, RIVERVIEW, FL 33579-7182
(813) 349-7568
(813) 349-7568
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS8265
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
266531000
—
FL
Enumeration date
08/31/2006
Last updated
01/19/2012
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