Ice, Shirley A
Ice, Shirley A is an individual health care provider with primary practice located at 10762 Se Us Highway 441 , Belleview FL 34420-3805. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Ice, Shirley A can be contacted via phone (352) 347-5225.Contact Information
Primary practice address
10762 Se Us Highway 441
Belleview FL 34420-3805
Phone: (352) 347-5225
Fax: (352) 347-1073
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ME71113 | Florida |
Profile Details
| NPI number | 1972581288 |
|---|---|
| LBN Legal business name | Ice, Shirley A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 6th, 2006 |
| Last updated | Jul 3rd, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972581288 | NPPES |
| Florida | MEDICAID | 253203400 |
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