Provider Demographics
NPI:1639157183
Name:SHEVLIN, AARON M (DPM)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:M
Last Name:SHEVLIN
Suffix:
Gender:M
Credentials:DPM
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Other - First Name:
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Mailing Address - Street 1:1696 SE HILLMOOR DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-7699
Mailing Address - Country:US
Mailing Address - Phone:772-335-1200
Mailing Address - Fax:772-335-1292
Practice Address - Street 1:1696 SE HILLMOOR DR
Practice Address - Street 2:STE B
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-7699
Practice Address - Country:US
Practice Address - Phone:772-335-1200
Practice Address - Fax:772-335-1292
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-05
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPO1009213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL041121300Medicaid
FL87557Medicare ID - Type Unspecified