10D0995168 CLIA NUMBER - SHANE C HERNESMAN MD PA

Laboratory Demographics

CLIA Number: 10D0995168

Facility Name: SHANE C HERNESMAN MD PA

Facility Address:
1980 N ATLANTIC AVE #630
COCOA BEACH, FL
ZIP 32931
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Facility Phone Number: 321 453-5888

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1952412652

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	10D0995168
LAB Type	Physician Office
Facility Name	SHANE C HERNESMAN MD PA
Street	1980 N ATLANTIC AVE #630
City	COCOA BEACH
State	FL
ZIP	32931
Phone	321 453-5888
CertificateType	4
CertificateEffectiveDate	1/11/2024
CertificateExpirationDate	1/10/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024