Provider Demographics
NPI:1902484660
Name:SHANDY, MATTHEW RAYMOND (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:RAYMOND
Last Name:SHANDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12953 PALMS WEST DR STE 101
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-4991
Mailing Address - Country:US
Mailing Address - Phone:561-795-2400
Mailing Address - Fax:
Practice Address - Street 1:12953 PALMS WEST DR STE 101
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-4991
Practice Address - Country:US
Practice Address - Phone:561-795-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-01
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1902484660207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology