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NPI Code Detail

MEDICARE: SHAELYN MONTGOMERY LEDOUX

MEDICARE: SHAELYN MONTGOMERY LEDOUX
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage TherapistMA102613FL

General Provider Information

NPI Number : 1144188046
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAELYN MONTGOMERY LEDOUX
Provider Business Mailing Address
First Line : 500 N WASHINGTON AVE STE 108
Second Line :
City : TITUSVILLE
State : FL
Zip : 32796-2759
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 500 N WASHINGTON AVE STE 108
Second Line :
City : TITUSVILLE
State : FL
Zip : 32796-2759
Country : US
Telephone Number : 321-966-8466
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2026
Last Update Date : 01/12/2026

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Directions to “ SHAELYN MONTGOMERY LEDOUX ” Practice Location

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