Provider Demographics
NPI:1528380672
Name:FLEMING, SHANA ANDREA (NP-C)
Entity Type:Individual
Prefix:
First Name:SHANA
Middle Name:ANDREA
Last Name:FLEMING
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6101 BLUE LAGOON DR STE 400
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2051
Mailing Address - Country:US
Mailing Address - Phone:772-286-0552
Mailing Address - Fax:772-286-7574
Practice Address - Street 1:1233 SE INDIAN ST STE 103
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997-5689
Practice Address - Country:US
Practice Address - Phone:772-286-0552
Practice Address - Fax:866-361-4852
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-17
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9186262363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily