Provider Demographics
NPI:1457376352
Name:RAHN SHAW MD PA
Entity Type:Organization
Organization Name:RAHN SHAW MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:LORIN
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-889-4711
Mailing Address - Street 1:202 N PARK AVE # 100
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-4148
Mailing Address - Country:US
Mailing Address - Phone:407-889-4711
Mailing Address - Fax:407-889-7742
Practice Address - Street 1:202 N PARK AVE # 100
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-4148
Practice Address - Country:US
Practice Address - Phone:407-889-4711
Practice Address - Fax:407-889-7742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1922099555OtherNPI FOR DR. SHAW
FL12484WOtherROBERTO S. PEREZ MD MEDICARE NUMBER
FL1568719425OtherNPI FOR DR. MCCALLA
FLE1300AOtherKELLY OSULLIVAN STOBBE PA MEDICARE NUMBER
MIN25400006OtherDR. PRISKA MEDICARE PIN
1639226459OtherROBERT LEMONS, MD NPI
MI1639373962OtherDR. PRISKA NPI
FL47663ZOtherRONALD SHAW MD MEDICARE NUMBER
FL1750372934OtherNPI FOR KELLY O'SULLIVAN STOBBE P-AC, MS
FL1700867553OtherNPI DR. PEREZ
FLK9529OtherMEDICARE GROUP PIN
FL1518281310OtherNPI DR. LUGO
MIN25400006OtherDR. PRISKA MEDICARE PIN