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Individual

MRS. LUCILLE SMITH SHILLINGFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2004 DARLINGTON DR., TAMPA, FL 33619-5718
(813) 417-1352
(813) 665-4394
Mailing address
2004 DARLINGTON DR, TAMPA, FL 33619-5718
(813) 417-1352
(813) 665-4394

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
677683396
FL
05
677683398
FL
Enumeration date
11/02/2010
Last updated
11/02/2010
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