Shirley a Ice MD PA

NPI #1720249410 in Dunnellon, Florida

Provider Information

NPI Number: 1720249410
Entity Type: Organization
Organization Name: Shirley a Ice MD PA
Primary Specialty: Family Medicine
Enumeration Date: Jun 24, 2008
Last Updated: Nov 2, 2010

Practice Location

Address: 19204 E PENNSYLVANIA AVE
City: Dunnellon
State: Florida
ZIP Code: 34432-6111
Phone: (352) 465-2449

Authorized Official

Name: SHIRLEY A ICE, MD
Title: PRESIDENT
Phone: (352) 465-2449

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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