Provider Demographics
NPI:1740290956
Name:SHIRER, JOSEPH A (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:A
Last Name:SHIRER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10000 W COLONIAL DR
Mailing Address - Street 2:SUITE 481
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-3498
Mailing Address - Country:US
Mailing Address - Phone:407-521-3550
Mailing Address - Fax:407-521-3557
Practice Address - Street 1:10000 W COLONIAL DR
Practice Address - Street 2:SUITE 481
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-3498
Practice Address - Country:US
Practice Address - Phone:407-521-3550
Practice Address - Fax:407-521-3557
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0053557207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL593233765OtherFEDERAL TAX ID
FL064736500Medicaid
FL07221AMedicare ID - Type Unspecified
FL593233765OtherFEDERAL TAX ID