Provider Demographics
NPI:1740637685
Name:ERMAN, SHAYNE M (DPM)
Entity type:Individual
Prefix:DR
First Name:SHAYNE
Middle Name:M
Last Name:ERMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1507 LAKELAND HILLS BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-3205
Mailing Address - Country:US
Mailing Address - Phone:863-250-4587
Mailing Address - Fax:
Practice Address - Street 1:1507 LAKELAND HILLS BLVD STE 101
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-3205
Practice Address - Country:US
Practice Address - Phone:863-250-4587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-20
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO4339213E00000X
OH36.003929213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist