Provider Demographics
NPI:1821023763
Name:SHEMESH, RON N (MD)
Entity Type:Individual
Prefix:DR
First Name:RON
Middle Name:N
Last Name:SHEMESH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 270693
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33688-0693
Mailing Address - Country:US
Mailing Address - Phone:813-935-2273
Mailing Address - Fax:813-908-0399
Practice Address - Street 1:3610 MADACA LN
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-2057
Practice Address - Country:US
Practice Address - Phone:813-935-2273
Practice Address - Fax:813-908-0399
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0063548207VG0400X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL18441OtherBCBS
FL371964200Medicaid
FL0703199OtherUNITED
FL593740909OtherCIGNA
FL237640OtherAVMED
FL593740909OtherHUMANA
FL593740909OtherHUMANA
FL371964200Medicaid