Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | ARNP9163555 | FL |
NPI | 1184738015 |
---|---|
Provider Name | Shannon Gaffney |
First Address | Orlando, FL 32886-2233 |
Second Address | Hollywood, FL 33021-5421 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2006 |
Last Update Date | 08/07/2007 |