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General NPI Number Information
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NPI Number | 1699648162
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Entity Type | Organization
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Legal Business Name | SHINYMAX
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Dates
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Enumeration Date | 09/29/2025
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 12651 LANIER RD
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City | JACKSONVILLE
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State | FL
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Zip | 32226-1755
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Country | US
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Telephone | 302-258-8986
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Fax |
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Provider Business Mailing Address
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Address Line | 12651 LANIER RD
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City | JACKSONVILLE
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State | FL
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Zip | 32226-1755
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Country | US
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Telephone | 904-736-3778
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Fax |
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Authorized Official
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Title or Position | NON EMMERGENCY MEDICAL DRIVER
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Name | GENET SCYPION
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Credential | DRIVER
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Telephone | 302-258-8986
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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