Healthcare Provider Details

I. General information

NPI: 1114865268
Provider Name (Legal Business Name): SHANICE R PAIGE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

584 MARDEN MEADOWS DR
APOPKA FL
32703-6977
US

IV. Provider business mailing address

584 MARDEN MEADOWS DR
APOPKA FL
32703-6977
US

V. Phone/Fax

Practice location:
  • Phone: 813-440-0141
  • Fax:
Mailing address:
  • Phone: 813-440-0141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberCNA392004
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: