Provider Demographics
NPI:1578045183
Name:SHELTON MEDICAL SERVICES INC
Entity type:Organization
Organization Name:SHELTON MEDICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YORDANKYS
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA-COLUMBIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-494-3264
Mailing Address - Street 1:3383 NW 7TH ST STE 308
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-4140
Mailing Address - Country:US
Mailing Address - Phone:786-801-0218
Mailing Address - Fax:786-353-9125
Practice Address - Street 1:3383 NW 7TH ST STE 308
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-4140
Practice Address - Country:US
Practice Address - Phone:786-801-0218
Practice Address - Fax:786-353-9125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL208D00000X
225100000X, 251S00000X, 261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational MedicineGroup - Multi-Specialty