Healthcare Provider Details

I. General information

NPI: 1437968807
Provider Name (Legal Business Name): SHELBZIE KATELEEN DORSAINVIL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHELBZIE PAUL

II. Dates (important events)

Enumeration Date: 12/31/2024
Last Update Date: 12/31/2024
Certification Date: 12/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 MIDDLEBURG CT
ORLANDO FL
32818-8261
US

IV. Provider business mailing address

4401 MIDDLEBURG CT
ORLANDO FL
32818-8261
US

V. Phone/Fax

Practice location:
  • Phone: 321-746-6097
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: