# SHIP SHAPE WATER FITNESS SPECIALISTS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356686943
- **Authorized official:** MS. SHARON M. SMITH AFAA TRAINER (FITNESS TRAINER)
- **Authorized official phone:** (386) 986-5655

## Contact information

- **Practice address:** 47 KALAMAZOO TRL, PALM COAST, FL 32164-5633
- **Practice address phone:** (386) 986-5655
- **Practice address fax:** (386) 313-1886
- **Mailing address:** 47 KALAMAZOO TRL, PALM COAST, FL 32164-5633
- **Mailing address phone:** (386) 986-5655
- **Mailing address fax:** (386) 313-1886

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | AEA 60145 | FL | — |
| 251K00000X | Public Health or Welfare Agency | AFAA 32385 | FL | Yes |

## Other

- **Enumeration date:** 12/07/2012
- **Last updated:** 12/07/2012