Provider Demographics
NPI:1164583654
Name:SHEBOVSKY, JEFFREY NEIL (DC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:NEIL
Last Name:SHEBOVSKY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11364 S ORANGE BLOSSOM TRL
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-9426
Mailing Address - Country:US
Mailing Address - Phone:407-857-6166
Mailing Address - Fax:407-857-0122
Practice Address - Street 1:11364 S ORANGE BLOSSOM TRL
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-9426
Practice Address - Country:US
Practice Address - Phone:407-857-6166
Practice Address - Fax:407-857-0122
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6499111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU48306Medicare UPIN
FL22970Medicare ID - Type Unspecified