Provider Demographics
NPI:1225017833
Name:SHULMAN, CARRIE L (MD)
Entity Type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:L
Last Name:SHULMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13121 66TH ST
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33773-1812
Mailing Address - Country:US
Mailing Address - Phone:727-314-8180
Mailing Address - Fax:727-474-6527
Practice Address - Street 1:13121 66TH ST
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33773-1812
Practice Address - Country:US
Practice Address - Phone:813-336-4461
Practice Address - Fax:813-336-4466
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME115244207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102425237Medicaid
FLP01330414OtherMEDICARE RAILROAD PROVIDER NUMBER
FL008483900Medicaid
FLHD386YMedicare PIN
FLHD386ZMedicare PIN
PA176326Medicare PIN