Provider Demographics
NPI:1235463001
Name:FLOYD, SHANNON (DPM)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:FLOYD
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4900 SW 46TH CT
Mailing Address - Street 2:2108
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-6264
Mailing Address - Country:US
Mailing Address - Phone:352-354-3730
Mailing Address - Fax:352-509-7340
Practice Address - Street 1:11834 COUNTY ROAD 101
Practice Address - Street 2:SUITE 203
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32162-9340
Practice Address - Country:US
Practice Address - Phone:352-633-8230
Practice Address - Fax:352-633-8232
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-28
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPO 3406213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery