Individual
EDITHA IGNACIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1636 E SHANGRI LA DR, DAYTONA BEACH, FL 32119-1520
(386) 767-8048
Mailing address
1636 E SHANGRI LA DR, DAYTONA BEACH, FL 32119-1520
(386) 767-8048
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
11691
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001574900
—
FL
Enumeration date
03/13/2014
Last updated
10/27/2025
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