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Search › Florida › 363LF0000X

Micaela Shannon

NPI 1023654647 · on the registry since 2019 · sole proprietor

Practice

Address
7016 Normandy Blvd
Jacksonville, FL 32205
Phone
(904) 783-2405
Fax
(904) 420-6101
Organisation at this address
West Jax Primary Care, P.A.
Inferred from a shared address, not stated in the registry.
Clinicians at this address
4

Registry record

Primary taxonomy
363LF0000X
363LF0000X
Also registered as
363LP2300X
163WE0003X
Licence states on file
FL
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2024-03-04

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Florida