Provider Demographics
NPI:1922582147
Name:SHLANSKY, VANESSA YVETTE (PA-C)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:YVETTE
Last Name:SHLANSKY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1353 SAWGRASS CT
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-5147
Mailing Address - Country:US
Mailing Address - Phone:813-787-4779
Mailing Address - Fax:
Practice Address - Street 1:12301 LAKE UNDERHILL RD STE 118
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-4510
Practice Address - Country:US
Practice Address - Phone:407-249-8870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-24
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9111538363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical