Buckley, Shelli Ann

Buckley, Shelli Ann is an sole proprietor health care provider with primary practice located at 2565 Judge Fran Jamieson Way , Viera FL 32940-5998. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist, which is considered as her primary health care specialty. Buckley, Shelli Ann can be contacted via phone (321) 634-3688.

Contact Information

Primary practice address
2565 Judge Fran Jamieson Way Viera FL 32940-5998
Phone: (321) 634-3688
Fax: (321) 504-0955
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist 222Q00000X

Profile Details

NPI number 1255456117
LBN Legal business name Buckley, Shelli Ann
Credentials Master of Education (MED)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 20th, 2007
Last updated Jan 8th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255456117 NPPES
Florida MEDICAID 811692000

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