1477068518 NPI number — SHANTE ALEAH SELLERS M.S.CCC-SLP

Table of content: DR. KAMALA DAWN SETHI M.D. (NPI 1417117656)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477068518 NPI number — SHANTE ALEAH SELLERS M.S.CCC-SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SELLERS
Provider First Name:
SHANTE
Provider Middle Name:
ALEAH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.S.CCC-SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SELLERS
Provider Other First Name:
SHANTE
Provider Other Middle Name:
ALEAH
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.S.,CCC-SLP
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1477068518
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/18/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7799 STYLES BLVD # 210
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KISSIMMEE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34747-1657
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-968-1754
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7799 STYLES BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KISSIMMEE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34747-1657
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
321-241-6093
Provider Business Practice Location Address Fax Number:
321-241-4400
Provider Enumeration Date:
12/12/2017

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  SA16516 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100067400 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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