Healthcare Provider Details

I. General information

NPI: 1861329310
Provider Name (Legal Business Name): SHARDONAY EUNIQUE BORDEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14555 NW 27TH AVE
CITRA FL
32113-3589
US

IV. Provider business mailing address

14555 NW 27TH AVE
CITRA FL
32113-3589
US

V. Phone/Fax

Practice location:
  • Phone: 352-362-4517
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: