Provider Demographics
NPI:1922055961
Name:SHEK, ROSABELLA (MD)
Entity Type:Individual
Prefix:
First Name:ROSABELLA
Middle Name:
Last Name:SHEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5857B 21ST AVE W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-5641
Mailing Address - Country:US
Mailing Address - Phone:941-761-2666
Mailing Address - Fax:941-761-2699
Practice Address - Street 1:5857B 21ST AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-5641
Practice Address - Country:US
Practice Address - Phone:941-761-2666
Practice Address - Fax:941-761-2699
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2017-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME81590207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE44929Medicare UPIN
FL51887YMedicare PIN