Healthcare Provider Details

I. General information

NPI: 1427768399
Provider Name (Legal Business Name): ALANA NICOLE SHOWN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2022
Last Update Date: 05/31/2023
Certification Date: 05/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 S HIAWASSEE RD STE 203
ORLANDO FL
32835-6317
US

IV. Provider business mailing address

2326 CONWAY RD APT A
ORLANDO FL
32812-8341
US

V. Phone/Fax

Practice location:
  • Phone: 407-286-4158
  • Fax:
Mailing address:
  • Phone: 757-560-0762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: