Provider Demographics
NPI:1306982418
Name:HARTMAN, SHIRLEY JOANNE (MD)
Entity type:Individual
Prefix:DR
First Name:SHIRLEY
Middle Name:JOANNE
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9283 SAN JOSE BLVD
Mailing Address - Street 2:BLDG 200 STE 1
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257
Mailing Address - Country:US
Mailing Address - Phone:904-268-5826
Mailing Address - Fax:904-268-5873
Practice Address - Street 1:9283 SAN JOSE BLVD
Practice Address - Street 2:BLDG 200 STE 1
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257
Practice Address - Country:US
Practice Address - Phone:904-268-5826
Practice Address - Fax:904-268-5873
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2025-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME45517207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL15996OtherBCBS
FLD52811Medicare UPIN