Individual
LAPORSHA SHANE RANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7614 LAVENDER LN, TAMPA, FL 33619-5634
(813) 568-3275
Mailing address
4211 E OKARA RD APT B, TAMPA, FL 33617-4439
(813) 568-3275
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
FL
Other
Enumeration date
07/21/2021
Last updated
07/21/2021
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