Provider Demographics
NPI:1134555055
Name:SHIFFLETT, STEWARD FRANKLIN JR
Entity type:Individual
Prefix:
First Name:STEWARD
Middle Name:FRANKLIN
Last Name:SHIFFLETT
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9220 102ND AVE NORTH
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33777
Mailing Address - Country:US
Mailing Address - Phone:813-241-0811
Mailing Address - Fax:727-209-0464
Practice Address - Street 1:9220 102ND AVE
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33777-1032
Practice Address - Country:US
Practice Address - Phone:813-241-0811
Practice Address - Fax:727-209-0464
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor