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:
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Health care specialties

SpecialtyCodeLicense #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 10 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 1497752679 NPPES
Florida MEDICAID 291344500

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