Anthony Shydohub MD PA

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

ME0061680 Issued in FL

Legal business name

ANTHONY SHYDOHUB MD PA

Practice address

4850 Sun N Lake Blvd
Sebring, FL 33872-2110

Phone

(863) 382-6088

Fax

(863) 382-9424

NPI assigned

Dec 6, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Anthony Andrew Shydohub, M.D.NPI 1275569899

Title

Doctor

Phone

(863) 382-6088

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anthony Andrew Shydohub, MD

  • Neurology Physician
  • Coral Springs, FL
  • NPI 1275569899
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972662286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 SUN N LAKE BLVD",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338722110",
            "telephone_number": "863-382-6088",
            "fax_number": "863-382-9424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 SUN N LAKE BLVD",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338722110",
            "telephone_number": "863-382-6088",
            "fax_number": "863-382-9424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHONY SHYDOHUB MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHYDOHUB",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "863-382-6088",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME0061680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Neurology Physician in Sebring, FL
• Providers in Sebring, FL by specialty
• Neurology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.