Provider Demographics
NPI:1649301029
Name:SHELL, SHERI A (LMT)
Entity type:Individual
Prefix:MRS
First Name:SHERI
Middle Name:A
Last Name:SHELL
Suffix:
Gender:F
Credentials:LMT
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 601
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33970-0601
Mailing Address - Country:US
Mailing Address - Phone:239-560-0647
Mailing Address - Fax:
Practice Address - Street 1:60 WESTMINSTER ST N
Practice Address - Street 2:SUITE D
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936-6518
Practice Address - Country:US
Practice Address - Phone:239-560-0647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA0027937174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist