Individual
SHANE ANTHONY BARNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
2100 SUMMERFIELD RD, WINTER PARK, FL 32792-5037
(407) 277-5861
Mailing address
2100 SUMMERFIELD RD, WINTER PARK, FL 32792-5037
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
6655
FL
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/15/2021
Last updated
07/15/2022
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