Shannon Delong in Winter Garden - Physician Assistant
Shannon Delong - NPI 1497752679
Shannon Delong is a Physician Assistant in Winter Garden, Florida. Shannon Delong practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Shannon Delong is 1497752679. The last update date is 2016-06-08.
Shannon Delong's current location address is 2000 Fowler Grove Blvd Fl 3, Winter Garden, Florida. You can contact this provider via phone number 4076140528 and fax number 4076140529. The mailing address for Shannon Delong is 2000 Fowler Grove Blvd Fl 3, Winter Garden, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Shannon Delong |
|---|---|
| Address | 2000 Fowler Grove Blvd Fl 3, Winter Garden, Florida |
| Phone Number | 4076140528 |
| Fax Number | 4076140529 |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1497752679 |
|---|---|
| Provider Enumeration Date | 2005-07-05 |
| Last Updated Date | 2016-06-08 |
Provider Mailing Address Detail
| Address | 2000 Fowler Grove Blvd Fl 3 |
|---|---|
| City | Winter Garden |
| State | Florida (FL) |
| Post Code | 347875050 |
| Phone Number | 4076140528 |
| Fax Number | 4076140529 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | PA9101942 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 291344500 | FL | -- |
Post Comment/ Review Below
Can you provide the Shannon Delong's physical address?
The Shannon Delong is physically located at 2000 Fowler Grove Blvd Fl 3, in the city of Winter Garden, FL, with the postal code 347875050.
When did the Shannon Delong receive its 1497752679?
The Shannon Delong was issued its 1497752679 on 2005-07-05, which is the date when the organization was assigned this unique identifier.
On what date did the Shannon Delong receive its 1497752679 assignment from the Centers for Medicare & Medicaid Services?
The Shannon Delong was assigned its 1497752679 by the Centers for Medicare & Medicaid Services on 2005-07-05.
As of what date were the Shannon Delong's details last updated?
The information pertaining to the Shannon Delong, including its address, specialty, and other details, was most recently updated on 2016-06-08.
As of what date were the details related to Shannon Delong most recently updated or revised?
The information pertaining to Shannon Delong, including its address, specialty, and other relevant details, was last updated or revised on 2016-06-08.