O'Hara, Shannon Dale
O'Hara, Shannon Dale is an sole proprietor health care provider with primary practice located at 1265 Viscaya Pkwy , Cape Coral FL 33990-3237. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology. Allopathic & Osteopathic Physicians / Obstetrics & Gynecology is her primary health care specialty. O'Hara, Shannon Dale can be contacted via phone (239) 574-2229.Contact Information
Primary practice address
1265 Viscaya Pkwy
Cape Coral FL 33990-3237
Phone: (239) 574-2229
Fax: (239) 574-2762
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | ME123468 | Florida |
Profile Details
| NPI number | 1306135454 |
|---|---|
| LBN Legal business name | O'Hara, Shannon Dale |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 29th, 2011 |
| Last updated | Oct 20th, 2017 - about 8 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 | 1306135454 | NPPES |
| Florida | Other | 1507R | BCBSFL |
| Florida | MEDICAID | 014864100 | BCBSFL |
| Florida | Other | IG110Z | BCBSFL |
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