| Shanlis Inc. | |
|
744 Colorado Ave Stuart FL 34994-3005 | |
| (772) 223-9988 | |
| (772) 223-9593 |
| Full Name | Shanlis Inc. |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 744 Colorado Ave, Stuart, Florida |
| Authorized Official Name and Position | Steven Edney (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 7722239988 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shanlis Inc. 744 Colorado Ave Stuart FL 34994-3005 Ph: (772) 223-9988 | Shanlis Inc. 744 Colorado Ave Stuart FL 34994-3005 Ph: (772) 223-9988 |
| NPI Number | 1396184248 |
|---|---|
| Provider Enumeration Date | 06/24/2013 |
| Last Update Date | 09/27/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396184248 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | PY5416 (Florida) | Primary |
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Secondary |
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