Provider Demographics
NPI:1811789969
Name:DEWITT, SHELBY (CST/CSFA)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:DEWITT
Suffix:
Gender:F
Credentials:CST/CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9405 N MARY AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-8645
Mailing Address - Country:US
Mailing Address - Phone:740-538-2389
Mailing Address - Fax:
Practice Address - Street 1:5 TAMPA GENERAL CIR STE 860
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3573
Practice Address - Country:US
Practice Address - Phone:813-660-6950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-22
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant