Organization
SHORELINE MENTAL HEALTH SERVICES LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA FABIANA BIANCOSPINO (OWNER)
(786) 382-1877
Entity
Organization
Contact information
Practice address
6900 TAVISTOCK LAKES BLVD STE 400, ORLANDO, FL 32827-7593
(786) 382-1877
Mailing address
6900 TAVISTOCK LAKES BLVD STE 400, ORLANDO, FL 32827-7593
(305) 317-2258
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
03/19/2021
Last updated
08/02/2022
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