Individual
MS. SHANI CACIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
970 LAKE CARILLON DR, ST PETERSBURG, FL 33716-1129
(813) 503-4594
Mailing address
10703 DOWRY AVE, TAMPA, FL 33615-3504
(813) 503-4594
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
127355
FL
261QR0800X
Recovery Care Clinic/Center
—
—
374J00000X
Doula
—
—
Other
Enumeration date
02/08/2021
Last updated
02/17/2021
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