MEDICARE: SHANICE SAVANNAH FABIO RN

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	367500000X	Certified Registered Nurse Anesthetist	9545378	FL

General Provider Information

NPI Number	:	1821943341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANICE SAVANNAH FABIO RN

Provider Business Mailing Address
First Line	:	12901 BRUCE B DOWNS BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33612-4799
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6637 COBBLE BLISS ST
Second Line	:
City	:	ZEPHYRHILLS
State	:	FL
Zip	:	33541-2695
Country	:	US
Telephone Number	:	954-512-8921
Fax Number	:

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

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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