Individual
SHANE FIORENTINI
Active
Individual
SHANE FIORENTINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AS0400X
Surgical Physician Assistant
Primary
MA065098
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16794376
CAQH
—
Enumeration date
09/14/2023
Last updated
04/28/2026
Update your record
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