Provider Demographics
NPI:1477709160
Name:SHYNGLE, LADAPO (MD, MPH)
Entity Type:Individual
Prefix:
First Name:LADAPO
Middle Name:
Last Name:SHYNGLE
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 WEBB DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-3904
Mailing Address - Country:US
Mailing Address - Phone:863-422-0001
Mailing Address - Fax:863-422-0003
Practice Address - Street 1:121 WEBB DR
Practice Address - Street 2:SUITE 100
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-3904
Practice Address - Country:US
Practice Address - Phone:863-422-0001
Practice Address - Fax:863-422-0003
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-13
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 94349208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice