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Individual

SHRONDA ALLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6519 NW 25TH TER, GAINESVILLE, FL 32653-1581
(352) 256-8182
Mailing address
PO BOX 141202, GAINESVILLE, FL 32614-1202
(352) 256-8182

Taxonomy

Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
233993
FL
376J00000X
Homemaker
233993
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
016312100
FL
05
016981900
FL
05
1992167894
FL
05
592200
FL
Enumeration date
12/11/2015
Last updated
11/13/2019
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