Provider Demographics
NPI:1003326463
Name:ORLANDO, SHANNON C
Entity Type:Individual
Prefix:MS
First Name:SHANNON
Middle Name:C
Last Name:ORLANDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 W MILLER ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-3910
Mailing Address - Country:US
Mailing Address - Phone:321-841-8393
Mailing Address - Fax:321-841-7930
Practice Address - Street 1:105 W MILLER ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-3910
Practice Address - Country:US
Practice Address - Phone:321-841-8393
Practice Address - Fax:321-841-7930
Is Sole Proprietor?:No
Enumeration Date:2017-10-11
Last Update Date:2017-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9327431363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health