| Doctor Name: | MRS. SHAWN KELLY LUNDBERG |
| NPI Number: | 1104038868 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | ARNP2120182 |
| Business Practice Address: | 18450 Us Highway 441 # C Mount Dora, FL - 327576707 |
| Business Phone Number: | 3523834966 |
| Business Fax Number: | 3523832001 |
| Mailing Address: | 2767 Monte Carlo Dr, EUSTIS |
| State: | FL |
| Postal Code: | 327267380 |
| Phone Number: | 3523834966 |
| Fax Number: | 3523832001 |
| NPI Enumeration Date: | 05/04/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LX0001X |
| License Number: | ARNP2120182 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Obstetrics & Gynecology |
| Taxonomy Definition: | |