Provider Demographics
NPI:1457346181
Name:SHORTT, JAMES D (M D)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:D
Last Name:SHORTT
Suffix:
Gender:M
Credentials:M D
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 25036
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34277-2036
Mailing Address - Country:US
Mailing Address - Phone:941-955-1231
Mailing Address - Fax:941-378-3444
Practice Address - Street 1:5741 BEE RIDGE RD
Practice Address - Street 2:STE 590
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-5064
Practice Address - Country:US
Practice Address - Phone:941-955-1231
Practice Address - Fax:941-378-3444
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-19
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME67392207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL28317OtherBLUE CROSS BLUE SHIELD
FL28317OtherBLUE CROSS BLUE SHIELD
FL28317AMedicare PIN