Healthcare Provider Details

I. General information

NPI: 1588086862
Provider Name (Legal Business Name): SHALINI SEMENTO BSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2014
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 LETOURNEAU CIRCLE BUILDING 90311
HURLBURT FIELD FL
32544
US

IV. Provider business mailing address

130 LETOURNEAU CIRCLE BUILDING 90311
HURLBURT FIELD FL
32544
US

V. Phone/Fax

Practice location:
  • Phone: 850-881-5262
  • Fax:
Mailing address:
  • Phone: 850-881-5262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW17388
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: