Provider Demographics
NPI:1669920302
Name:SHOAFF, CAITLYN
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:
Last Name:SHOAFF
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 1:613 WHITE CRANE CT
Mailing Address - Street 2:
Mailing Address - City:CHULUOTA
Mailing Address - State:FL
Mailing Address - Zip Code:32766-6673
Mailing Address - Country:US
Mailing Address - Phone:407-325-7496
Mailing Address - Fax:
Practice Address - Street 1:613 WHITE CRANE CT
Practice Address - Street 2:
Practice Address - City:CHULUOTA
Practice Address - State:FL
Practice Address - Zip Code:32766-6673
Practice Address - Country:US
Practice Address - Phone:407-325-7496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-12
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer