Jaquish, Shelley Sue
Jaquish, Shelley Sue is an sole proprietor health care provider with primary practice located at 6827 First Avenue South Suite 100, St Petersburg FL 33707-4516. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Otolaryngic Allergy, Allopathic & Osteopathic Physicians / Otolaryngology. Allopathic & Osteopathic Physicians / Otolaryngology is her primary health care specialty. Jaquish, Shelley Sue can be contacted via phone (727) 341-0551.Contact Information
Primary practice address
6827 First Avenue South Suite 100
St Petersburg FL 33707-4516
Phone: (727) 341-0551
Fax: (727) 341-0332
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otolaryngic Allergy | 207YX0602X | ME82762 | Florida |
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | ME82762 | Florida |
Profile Details
| NPI number | 1558329300 |
|---|---|
| LBN Legal business name | Jaquish, Shelley Sue |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 2nd, 2006 |
| Last updated | Apr 24th, 2019 - about 6 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 | 1558329300 | NPPES |
| Florida | Other | 280250 | AVMED |
| Florida | Other | 2597386 | AVMED |
| Florida | Other | 1000331 | AVMED |
| Florida | Other | 220342 | AVMED |
| Florida | Other | 01150 | AVMED |
| Florida | MEDICAID | 261879600 | AVMED |
| Florida | Other | 3839012002 | AVMED |
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