Individual
SHANIQUE L AYALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6045 HOLLYWOOD ST, JUPITER, FL 33458-6730
(561) 563-6488
Mailing address
PO BOX 671, JUPITER, FL 33468-0671
(561) 563-6488
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00000000000000000000
—
FL
Enumeration date
08/22/2018
Last updated
08/22/2018
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