Provider Demographics
NPI:1265734560
Name:MINDBODYSPIRIT CARE INC
Entity type:Organization
Organization Name:MINDBODYSPIRIT CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEMESH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-505-1948
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:813-749-9075
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:813-749-9075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-19
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherEIN