Provider Demographics
NPI:1336436211
Name:MAK, SHEILA SHUK-YIN (DO)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:SHUK-YIN
Last Name:MAK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2370 DREW ST
Mailing Address - Street 2:UNIT B
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-3318
Mailing Address - Country:US
Mailing Address - Phone:727-461-1543
Mailing Address - Fax:727-449-0594
Practice Address - Street 1:2370 DREW ST
Practice Address - Street 2:UNIT B
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-3318
Practice Address - Country:US
Practice Address - Phone:727-461-1543
Practice Address - Fax:727-449-0594
Is Sole Proprietor?:No
Enumeration Date:2011-06-29
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08954300208000000X
PAOS015663208000000X
FLOS12798208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL012933700Medicaid