Provider Demographics
NPI:1992711352
Name:FARMER, SHELIA F (MD)
Entity type:Individual
Prefix:
First Name:SHELIA
Middle Name:F
Last Name:FARMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5101 N. ARMENIA AVE.
Mailing Address - Street 2:B
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603
Mailing Address - Country:US
Mailing Address - Phone:813-414-0279
Mailing Address - Fax:813-414-0358
Practice Address - Street 1:5101 N. ARMENIA AVE.
Practice Address - Street 2:B
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603
Practice Address - Country:US
Practice Address - Phone:813-414-0279
Practice Address - Fax:813-414-0358
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME32555207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL30435AMedicare ID - Type Unspecified
FLE14690Medicare UPIN