Montgomery, Shacoya
Montgomery, Shacoya is an sole proprietor health care provider with primary practice located at 3909 Sandhill Crane Dr , Lakeland FL 33811-1862. She recently has only one registered license in Ambulatory Health Care Facilities / Developmental Disabilities, which is considered as her primary health care specialty. Montgomery, Shacoya can be contacted via phone (863) 617-5840.Contact Information
Primary practice address
3909 Sandhill Crane Dr
Lakeland FL 33811-1862
Phone: (863) 617-5840
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Developmental Disabilities | 261QD1600X |
Profile Details
| NPI number | 1316416381 |
|---|---|
| LBN Legal business name | Montgomery, Shacoya |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 19th, 2018 |
| Last updated | Nov 19th, 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 | 1316416381 | NPPES |
| Florida | MEDICAID | 824729967 |
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