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NPI Code Detail

MEDICARE: SHANAN LAY

MEDICARE:   SHANAN  LAY
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
1251E00000XHome Health Agency34666FL
2251E00000XHome Health Agency239003FL

General Provider Information

NPI Number : 1568144681
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANAN LAY
Provider Business Mailing Address
First Line : 3701 N 54TH ST
Second Line :
City : TAMPA
State : FL
Zip : 33619-1423
Country : US
Telephone Number : 561-244-2513
Fax Number :
Provider Business Practice Location Address
First Line : 3701 N 54TH ST
Second Line :
City : TAMPA
State : FL
Zip : 33619-1423
Country : US
Telephone Number : 561-244-2513
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2023
Last Update Date : 08/07/2023

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Directions to “ SHANAN LAY ” Practice Location

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