Provider Demographics
NPI:1386369700
Name:ANAMARIA SHANLEY, MSN, APRN, PLLC
Entity type:Organization
Organization Name:ANAMARIA SHANLEY, MSN, APRN, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANAMARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:407-917-6015
Mailing Address - Street 1:3564 AVALON PARK EAST BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-7365
Mailing Address - Country:US
Mailing Address - Phone:407-917-6015
Mailing Address - Fax:949-437-8401
Practice Address - Street 1:1954 HOWELL BRANCH RD
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-1041
Practice Address - Country:US
Practice Address - Phone:407-917-6015
Practice Address - Fax:949-437-8401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-07
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health