Individual
SERENA ANITA SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
4440 OLD TAMPA HWY, LAKELAND, FL 33811-1135
(999) 999-9999
Mailing address
4440 OLD TAMPA HWY, LAKELAND, FL 33811-1135
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL6525
FL
Other
Enumeration date
01/04/2019
Last updated
06/27/2024
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