Chavis, Shelby J
Chavis, Shelby J is an individual health care provider with primary practice located at 2018 Talley Rd , Leesburg FL 34748. She recently has only one registered license in Other Service Providers / Case Manager/Care Coordinator, which is considered as her primary health care specialty. Chavis, Shelby J can be contacted via phone (352) 315-7420.Contact Information
Primary practice address
2018 Talley Rd
Leesburg FL 34748
Phone: (352) 315-7420
Fax: (352) 315-7587
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Case Manager/Care Coordinator | 171M00000X |
Profile Details
| NPI number | 1750817078 |
|---|---|
| LBN Legal business name | Chavis, Shelby J |
| Credentials | Master of Arts (MA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 5th, 2017 |
| Last updated | Jul 3rd, 2018 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750817078 | NPPES |
| Florida | MEDICAID | 021220700 |
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