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General NPI Number Information
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NPI Number | 1033832936
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Entity Type | Organization
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Legal Business Name | SHARE YOUR STORY, LLC
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Dates
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Enumeration Date | 09/26/2022
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Last Update Date | 09/26/2022
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Provider Practice Location Address
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Address Line | 7208 W SAND LAKE RD STE 305
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City | ORLANDO
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State | FL
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Zip | 32819-5279
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Country | US
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Telephone | 407-235-5498
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Fax |
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Provider Business Mailing Address
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Address Line | 7208 W SAND LAKE RD STE 305
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City | ORLANDO
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State | FL
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Zip | 32819-5279
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Country | US
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Telephone | 407-235-5498
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | EILEEN DIAZ
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Credential |
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Telephone | 407-235-4598
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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