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Contact Information

FREDERICK B SHANNON, DO
15821 HOLLYFERN CT
FORT MYERS, FL33908
 Phone: 239-432-5100
 Fax: 239-432-0629
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for FREDERICK B SHANNON · (Male)

NPI # 1518971225
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 07/28/2006
Last updated 03/06/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • FL License # OS4993
  • FL Medicaid 372036500
  • FL Other 4283415 AETNA
  • FL Other 195066 AMERIGROUP
  • FL Other 207270 AVMED
  • FL Other 80729 BLUE CROSS BLUE SHIELD
  • FL Other 2017372-007 CIGNA
  • FL Other 16065 STAYWELL HEALTHY KIDS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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