Provider Demographics
NPI:1770042210
Name:WHITE, SHAMEEKA A
Entity Type:Individual
Prefix:
First Name:SHAMEEKA
Middle Name:A
Last Name:WHITE
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 1:8481 SE CITRUS WAY
Mailing Address - Street 2:
Mailing Address - City:HOBE SOUND
Mailing Address - State:FL
Mailing Address - Zip Code:33455-7107
Mailing Address - Country:US
Mailing Address - Phone:772-634-5418
Mailing Address - Fax:
Practice Address - Street 1:8481 SE CITRUS WAY
Practice Address - Street 2:
Practice Address - City:HOBE SOUND
Practice Address - State:FL
Practice Address - Zip Code:33455-7107
Practice Address - Country:US
Practice Address - Phone:772-634-5418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-14
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care