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NPI Code Detail

MEDICARE: AIYANA MARIE SHAW

MEDICARE: AIYANA MARIE SHAW
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
1106S00000XBehavior TechnicianFL

General Provider Information

NPI Number : 1649137266
Entity Type Code : Individual
Provider Name (Legal Business Name) : AIYANA MARIE SHAW
Provider Business Mailing Address
First Line : 8400 49TH ST N APT 1701
Second Line :
City : PINELLAS PARK
State : FL
Zip : 33781-1549
Country : US
Telephone Number : 188-875-4039
Fax Number :
Provider Business Practice Location Address
First Line : 10901 ROOSEVELT BLVD N STE 100
Second Line :
City : SAINT PETERSBURG
State : FL
Zip : 33716-2305
Country : US
Telephone Number : 888-754-0398
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2026
Last Update Date : 01/06/2026

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Directions to “ AIYANA MARIE SHAW ” Practice Location

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