Provider Demographics
NPI:1689679292
Name:SHERAN, SHONDA YVETTE (MD)
Entity Type:Individual
Prefix:
First Name:SHONDA
Middle Name:YVETTE
Last Name:SHERAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHONDA
Other - Middle Name:Y
Other - Last Name:PERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 748817
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-8817
Mailing Address - Country:US
Mailing Address - Phone:813-286-0333
Mailing Address - Fax:813-286-1806
Practice Address - Street 1:4321 N MACDILL AVE
Practice Address - Street 2:SUITE #205
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6388
Practice Address - Country:US
Practice Address - Phone:813-961-7440
Practice Address - Fax:813-962-0951
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME85370207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL269077200Medicaid
FL269077200Medicaid
FL62703XMedicare PIN