Provider Demographics
NPI:1598945297
Name:SHUFELT, CHRISANDRA LEE (MD, MS)
Entity Type:Individual
Prefix:DR
First Name:CHRISANDRA
Middle Name:LEE
Last Name:SHUFELT
Suffix:
Gender:F
Credentials:MD, MS
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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:310-423-9660
Mailing Address - Fax:904-953-2000
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:310-423-9660
Practice Address - Fax:904-953-2000
Is Sole Proprietor?:No
Enumeration Date:2007-11-09
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA94577207R00000X
FLME154983207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine