Richard Robert Shaker, DC | |
3314 Henderson Blvd, Ste 203, Tampa, FL 33609-2998 | |
(813) 876-9552 | |
(813) 877-1558 |
Full Name | Richard Robert Shaker |
---|---|
Gender | Male |
Speciality | Chiropractor |
Location | 3314 Henderson Blvd, Tampa, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1417931163 | NPI | - | NPPES |
381409200 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | CH6025 (Florida) | Primary |
Provider Name | Richard R. Shaker Dc Pa |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1215713102 PECOS PAC ID: 2860934742 Enrollment ID: O20240606002592 |
Mailing Address | Practice Location Address |
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Richard Robert Shaker, DC 3314 Henderson Blvd, Ste 203, Tampa, FL 33609-2998 Ph: (813) 876-9552 | Richard Robert Shaker, DC 3314 Henderson Blvd, Ste 203, Tampa, FL 33609-2998 Ph: (813) 876-9552 |
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