Provider Demographics
NPI:1215225370
Name:SHUMSKI, MICHAEL J
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:SHUMSKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 E PAR ST STE 2000
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-3943
Mailing Address - Country:US
Mailing Address - Phone:407-843-5665
Mailing Address - Fax:407-872-7939
Practice Address - Street 1:120 E PAR ST STE 2000
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-3943
Practice Address - Country:US
Practice Address - Phone:407-843-5665
Practice Address - Fax:407-872-7939
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-11
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME127795207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME127795OtherOPHTHAMOLOGY