Riley, Shannon

Riley, Shannon is an individual health care provider with primary practice located at 570 Memorial Cir Ste 110 , Ormond Beach FL 32174-5063. She recently has only one registered license in Technologists, Technicians & Other Technical Service Providers / Laboratory Management, which is considered as her primary health care specialty. Riley, Shannon can be contacted via phone (386) 951-5571.

Contact Information

Primary practice address
570 Memorial Cir Ste 110 Ormond Beach FL 32174-5063
Phone: (386) 951-5571
Fax: (386) 287-5776
Website:
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Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Laboratory Management 246QL0900X

Profile Details

NPI number 1013664796
LBN Legal business name Riley, Shannon
Credentials VICE PRESIDENT OF OP
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 3rd, 2022
Last updated Mar 3rd, 2022 - about 3 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 1013664796 NPPES
Florida Other 10D2251415 CLIA

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