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NPI Code Detail

MEDICARE: ILANA SHAW

MEDICARE:   ILANA  SHAW
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
1235Z00000XSpeech-Language PathologistSA23897FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1SI3619OTHERFLFLORIDA DEPARTMENT OF HEALTH

General Provider Information

NPI Number : 1861064388
Entity Type Code : Individual
Provider Name (Legal Business Name) : ILANA SHAW
Provider Business Mailing Address
First Line : 1675 SMOKETREE CIR
Second Line :
City : APOPKA
State : FL
Zip : 32712-8178
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9401 W COLONIAL DR STE 206
Second Line :
City : OCOEE
State : FL
Zip : 34761-6808
Country : US
Telephone Number : 321-638-6004
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2021
Last Update Date : 07/01/2026

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Directions to “ ILANA SHAW ” Practice Location

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