Provider Demographics
NPI:1861858870
Name:SHLAIN, IRINA (LAC AP)
Entity Type:Individual
Prefix:MRS
First Name:IRINA
Middle Name:
Last Name:SHLAIN
Suffix:
Gender:F
Credentials:LAC AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22055 HIGHWAY 441 N
Mailing Address - Street 2:
Mailing Address - City:MICANOPY
Mailing Address - State:FL
Mailing Address - Zip Code:32667-7525
Mailing Address - Country:US
Mailing Address - Phone:352-448-5488
Mailing Address - Fax:
Practice Address - Street 1:22055 HIGHWAY 441 N
Practice Address - Street 2:
Practice Address - City:MICANOPY
Practice Address - State:FL
Practice Address - Zip Code:32667-7525
Practice Address - Country:US
Practice Address - Phone:267-736-3411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-06
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3560171100000X
374J00000X
FL590176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No171100000XOther Service ProvidersAcupuncturist
No374J00000XNursing Service Related ProvidersDoula