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Individual

SHANNON MILTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
116 AZALEA DR, DAYTONA BEACH, FL 32117-4802
(386) 983-5980
Mailing address
116 AZALEA DR, DAYTONA BEACH, FL 32117-4802
(321) 655-9309

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
FL
376J00000X
Homemaker
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
850765248
FL
Enumeration date
07/28/2018
Last updated
07/25/2021
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