Provider Demographics
NPI:1699477034
Name:DELANIE SHEA LLC
Entity type:Organization
Organization Name:DELANIE SHEA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNT MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:570-460-9695
Mailing Address - Street 1:15819 STARLING CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:LITHIA
Mailing Address - State:FL
Mailing Address - Zip Code:33547-3974
Mailing Address - Country:US
Mailing Address - Phone:570-460-9695
Mailing Address - Fax:
Practice Address - Street 1:4100 W KENNEDY BLVD STE 335
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-2257
Practice Address - Country:US
Practice Address - Phone:570-460-9695
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-20
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty