Provider Demographics
NPI:1093133712
Name:GONZALEZ-JAMES, SHANNON (DC)
Entity type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:
Last Name:GONZALEZ-JAMES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9550 BAYMEADOWS RD STE 9
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-0748
Mailing Address - Country:US
Mailing Address - Phone:904-730-5115
Mailing Address - Fax:904-828-5552
Practice Address - Street 1:9550 BAYMEADOWS RD STE 9
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-0748
Practice Address - Country:US
Practice Address - Phone:904-730-5115
Practice Address - Fax:904-828-5552
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-31
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11082111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor