Healthcare Provider Details

I. General information

NPI: 1285543389
Provider Name (Legal Business Name): AILEEN SHIN-ANN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4255 ALAFAYA TRL
OVIEDO FL
32765-9410
US

IV. Provider business mailing address

12186 SUMTER DR
ORLANDO FL
32824-7362
US

V. Phone/Fax

Practice location:
  • Phone: 407-359-6989
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS71439
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: