Rebala, Shobha

Rebala, Shobha is an individual health care provider with primary practice located at 2617 Mitcham Dr Ste 102 , Tallahassee FL 32308-5479. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Gerontology, Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Physician Assistants & Advanced Practice Nursing Providers / Primary Care is her primary health care specialty. Rebala, Shobha can be contacted via phone (850) 878-1171.

Contact Information

Primary practice address
2617 Mitcham Dr Ste 102 Tallahassee FL 32308-5479
Phone: (850) 878-1171
Fax: (850) 942-1291
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 364SG0600X ARNP9179052 Florida
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X ARNP9179052 Florida
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X ARNP9179052 Florida

Profile Details

NPI number 1457731663
LBN Legal business name Rebala, Shobha
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2015
Last updated Nov 29th, 2019 - about 7 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 1457731663 NPPES
Florida MEDICAID 018671700
Florida MEDICAID 060754100

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