Individual
MRS. ALISSA JAN SHAVALIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1112 GOODLETTE RD N STE 204, NAPLES, FL 34102-5499
(239) 262-4519
(239) 262-5672
Mailing address
1112 GOODLETTE RD N STE 204, NAPLES, FL 34102-5499
(239) 262-4519
(239) 262-5672
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9103314
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00397448
RAILROAD MEDICARE
FL
Enumeration date
06/07/2006
Last updated
08/05/2008
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