| Doctor Name: | SHELLY L. CHVOTZKIN |
| NPI Number: | 1801094677 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DO |
| License Number: | 25MB08188500 |
| Business Practice Address: | 16271 Bass Rd Fort Myers, FL - 339083616 |
| Business Phone Number: | 2393437100 |
| Business Fax Number: | 2393437190 |
| Mailing Address: | Po Box 2147, FORT MYERS |
| State: | FL |
| Postal Code: | 339022147 |
| Phone Number: | 2394241449 |
| Fax Number: | 2394241421 |
| NPI Enumeration Date: | 07/03/2007 |
| NPI Last Update Date: | 04/22/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 25MB08188500 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NJ |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |