Individual
MS. SHAYNA FASANELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5540 PGA BLVD STE 200, PALM BEACH GARDENS, FL 33418-3987
(561) 571-4000
(561) 491-2271
Mailing address
5540 PGA BLVD STE 200, PALM BEACH GARDENS, FL 33418-3987
(561) 571-4000
(561) 491-2271
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
5601008742
MI
363AS0400X
Surgical Physician Assistant
Primary
PA9112616
FL
Other
Enumeration date
06/14/2018
Last updated
01/28/2020
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