Provider Demographics
NPI:1497044739
Name:SHAPIRO, ANNA BOVILL (M D)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:BOVILL
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:SAUDA
Other - Last Name:BOVILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4500 SAN PABLO RD S
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-1865
Mailing Address - Country:US
Mailing Address - Phone:904-953-2000
Mailing Address - Fax:
Practice Address - Street 1:4500 SAN PABLO RD S
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-1865
Practice Address - Country:US
Practice Address - Phone:904-953-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-06
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME146725207L00000X
CAA124456207LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology