Individual
SHANTAVIA SHANICE TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2302 N CRYSTAL LAKE DR, LAKELAND, FL 33801-6527
(863) 934-9433
Mailing address
2302 N CRYSTAL LAKE DR, LAKELAND, FL 33801-6527
(863) 934-9433
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
FL
Other
Enumeration date
07/29/2026
Last updated
07/29/2026
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