Delong, Shannon
Delong, Shannon is an individual health care provider with primary practice located at 2000 Fowler Grove Blvd Fl 3 , Winter Garden FL 34787-5050. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Delong, Shannon can be contacted via phone (407) 614-0528.Contact Information
Primary practice address
2000 Fowler Grove Blvd Fl 3
Winter Garden FL 34787-5050
Phone: (407) 614-0528
Fax: (407) 614-0529
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA9101942 | Florida |
Profile Details
NPI number | 1497752679 |
---|---|
LBN Legal business name | Delong, Shannon |
Credentials | Physician's Assistant Certified (PA-C) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 5th, 2005 |
Last updated | Jun 8th, 2016 - about 8 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 | 1497752679 | NPPES |
Florida | MEDICAID | 291344500 |
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