MEDICARE: ZILANDRA CARLISHA-SHONTAYE MINCEY LPN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	5253653	FL

General Provider Information

NPI Number	:	1558228411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZILANDRA CARLISHA-SHONTAYE MINCEY LPN

Provider Business Mailing Address
First Line	:	500 ACME ST APT 205
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32211-7494
Country	:	US
Telephone Number	:	994-327-3237
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 ACME ST APT 205
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32211-7494
Country	:	US
Telephone Number	:	994-327-3237
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	01/05/2026

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Directions to “ ZILANDRA CARLISHA-SHONTAYE MINCEY LPN” Practice Location

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