Provider Demographics
NPI:1720683899
Name:GRIER, SHAMARON ALEEYA (PA-C)
Entity Type:Individual
Prefix:
First Name:SHAMARON
Middle Name:ALEEYA
Last Name:GRIER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SHAMARON
Other - Middle Name:ALEEYA
Other - Last Name:BATCHELOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2501 N ORANGE AVE STE 401
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-4644
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:601 E ROLLINS ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1248
Practice Address - Country:US
Practice Address - Phone:407-303-7283
Practice Address - Fax:407-303-0347
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-04
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA10172363A00000X
FLPA9115375363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant