Provider Demographics
NPI:1750358909
Name:MR SHER MD INC
Entity type:Organization
Organization Name:MR SHER MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MANDEL
Authorized Official - Middle Name:REID
Authorized Official - Last Name:SHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-397-8557
Mailing Address - Street 1:11200 SEMINOLE BLVD
Mailing Address - Street 2:#310
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33778-3239
Mailing Address - Country:US
Mailing Address - Phone:727-397-8557
Mailing Address - Fax:727-397-4459
Practice Address - Street 1:11200 SEMINOLE BLVD
Practice Address - Street 2:#310
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33778-3239
Practice Address - Country:US
Practice Address - Phone:727-397-8557
Practice Address - Fax:727-397-4459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-07
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
K3533OtherBCBS
K3533Medicare ID - Type Unspecified