Russel K Shaw (NPI# 1518914795, PAC ID# 4284699737) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL SURGERY.
| Nation Provider ID (NPI) | 1518914795 |
| PAC ID by PECOS | 4284699737 |
| Professional Enrollment ID | I20041123000934 |
| Full Name | Russel K Shaw |
| Address |
247 San Marcos Ave Sanford FL 32771-1432 |
| Phone Number | 4073210060 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF SOUTHERN CALIFORNIA SCHOOL OF MEDICINE |
| Graduation Year | 1965 |
| Primary Specialty | GENERAL SURGERY |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 100161 | CENTRAL FLORIDA REGIONAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 247 San Marcos Ave, Sanford, FL 32771-1432 | 4073210060 |
| Street Address |
247 SAN MARCOS AVE |
| City | SANFORD |
| State | FL |
| Zip | 32771-1432 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Angeline Quinones | Nurse Practitioner | Fl-i Medical Services LLC | 4525 Internatinal Pkwy, Sanford, FL 32771 |
| William R Vivas | Podiatry | Central Florida Family Health Center Inc | 2400 State Rd, Suite 415, Sanford, FL 32771 |
| Emma M Herrera | General Practice | Central Florida Family Health Center Inc | 2400 State Rd, Suite 415, Sanford, FL 32771 |
| Peter H Oostwouder | Family Medicine | Central Florida Family Health Center Inc | 2400 State Rd, Suite 415, Sanford, FL 32771 |
| Dana Tate Solomon | Physician Assistant | Central Florida Family Health Center Inc | 2400 State Rd, Suite 415, Sanford, FL 32771 |
| Kim-cheree T Jackson | Nurse Practitioner | Central Florida Family Health Center Inc | 2400 State Rd, Suite 415, Sanford, FL 32771 |
| Luisa O Mena | General Practice | Central Florida Family Health Center Inc | 2400 State Rd, Suite 415, Sanford, FL 32771 |
| Theresa L Mantle | Nurse Practitioner | Central Florida Family Health Center Inc | 2400 State Rd, Suite 415, Sanford, FL 32771 |
| Sherhonda Fevrier | Nurse Practitioner | Central Florida Family Health Center Inc | 2400 State Rd, Suite 415, Sanford, FL 32771 |
| Jennifer F Simpkins | Family Practice | Central Florida Family Health Center Inc | 2400 State Rd, Sanford, FL 32771 |
| Find all physicians in zip 32771 | |||
| City | SANFORD |
| Zip Code | 32771 |
| Specialty | GENERAL SURGERY |
| City + Specialty | SANFORD + GENERAL SURGERY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.