Provider Demographics
NPI:1235529645
Name:SHEA, NATALIE (AP)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:SHEA
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 N BAY HARBOR DR
Mailing Address - Street 2:
Mailing Address - City:KEY LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33037-2016
Mailing Address - Country:US
Mailing Address - Phone:305-609-8989
Mailing Address - Fax:
Practice Address - Street 1:175 WRENN ST
Practice Address - Street 2:
Practice Address - City:TAVERNIER
Practice Address - State:FL
Practice Address - Zip Code:33070-2335
Practice Address - Country:US
Practice Address - Phone:305-609-8989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-23
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3491171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist