MEDICARE: GLORIA SHAFAYE ANTWI

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
1	251E00000X	Home Health Agency	358905	FL

General Provider Information

NPI Number	:	1518829225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLORIA SHAFAYE ANTWI

Provider Business Mailing Address
First Line	:	3513 KINGSTON ST N
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33713-1324
Country	:	US
Telephone Number	:	727-815-2915
Fax Number	:

Provider Business Practice Location Address
First Line	:	3513 KINGSTON ST N
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33713-1324
Country	:	US
Telephone Number	:	727-815-2915
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2025
Last Update Date	:	12/01/2025

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Directions to “ GLORIA SHAFAYE ANTWI ” Practice Location

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