Individual
AMBERAL SHANTA HANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
204 TIFTON ST, WINTER HAVEN, FL 33880-6174
(863) 400-9513
Mailing address
204 TIFTON ST, WINTER HAVEN, FL 33880-6174
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5199753
FL
Other
Enumeration date
06/16/2026
Last updated
06/16/2026
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