Individual
LAVERN VICTORIA SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7901 NW 43RD ST, CORAL SPRINGS, FL 33065-1900
(754) 702-8836
(754) 702-2621
Mailing address
7901 NW 43RD ST, CORAL SPRINGS, FL 33065-1900
(754) 702-8836
(754) 702-2621
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5199350
FL
Other
Enumeration date
08/04/2021
Last updated
08/04/2021
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