Healthcare Provider Details

I. General information

NPI: 1447633763
Provider Name (Legal Business Name): SHANNON LORRAINE MILAM ARNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHANNON LORRAINE COLEMAN

II. Dates (important events)

Enumeration Date: 07/06/2015
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 UNIVERSITY BLVD STE 204
JUPITER FL
33458-2788
US

IV. Provider business mailing address

6101 BLUE LAGOON DR STE 400
MIAMI FL
33126-2051
US

V. Phone/Fax

Practice location:
  • Phone: 561-564-0665
  • Fax:
Mailing address:
  • Phone: 305-500-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberARNP9278663
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN9278663
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: