Healthcare Provider Details

I. General information

NPI: 1376476788
Provider Name (Legal Business Name): SHEENA EARLY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

428 BELLA VIDA BLVD
ORLANDO FL
32828-6716
US

IV. Provider business mailing address

1106 CROSSTOWN WAY UNIT 2203
ORLANDO FL
32807-8329
US

V. Phone/Fax

Practice location:
  • Phone: 321-532-2082
  • Fax:
Mailing address:
  • Phone: 321-532-2082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code247ZC0005X
TaxonomyClinical Laboratory Director (Non-physician)
License Number
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code246QL0900X
TaxonomyLaboratory Management Specialist/Technologist
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: