Gibson, Shanon T

Gibson, Shanon T is an sole proprietor health care provider with primary practice located at 1044 Lakeside Dr , Apopka FL 32712-8115. She recently has only one registered license in Agencies / Early Intervention Provider Agency, which is considered as her primary health care specialty. Gibson, Shanon T can be contacted via phone (077) 660-0884.

Contact Information

Primary practice address
1044 Lakeside Dr Apopka FL 32712-8115
Phone: (077) 660-0884
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Agencies / Early Intervention Provider Agency 252Y00000X

Profile Details

NPI number 1962033670
LBN Legal business name Gibson, Shanon T
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 31st, 2020
Last updated Sep 27th, 2020 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962033670 NPPES
Florida MEDICAID 106038000

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