Provider Demographics
NPI:1679941934
Name:SHINKLE, WAYNE LEROY JR (RRT)
Entity Type:Individual
Prefix:MR
First Name:WAYNE
Middle Name:LEROY
Last Name:SHINKLE
Suffix:JR
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1276 SWISS LN
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32738-6907
Mailing Address - Country:US
Mailing Address - Phone:407-919-9235
Mailing Address - Fax:
Practice Address - Street 1:1276 SWISS LN
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32738-6907
Practice Address - Country:US
Practice Address - Phone:407-919-9235
Practice Address - Fax:407-343-8565
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-03
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT111352279H0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredHome Health