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Individual

MRS. ELANA L SHACKELFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
1111 S. ORANGE AVE, 4TH FLOOR, ORLANDO, FL 32806
(407) 992-0660
(407) 992-7702
Mailing address
1111 S. ORANGE AVE, 4TH FLOOR, ORLANDO, FL 32806
(407) 992-0660
(407) 992-7702

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME89879
FL
207R00000X
Internal Medicine Physician
ARNP9203677
FL

Other

Enumeration date
01/11/2006
Last updated
01/12/2009
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