Provider Demographics
NPI:1861220451
Name:SHAEVITCH, DANA (CGC)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:SHAEVITCH
Suffix:
Gender:F
Credentials:CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2911 HEIGHT ST APT 1421
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34240-1355
Mailing Address - Country:US
Mailing Address - Phone:941-413-9110
Mailing Address - Fax:
Practice Address - Street 1:1717 S OSPREY AVE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-3500
Practice Address - Country:US
Practice Address - Phone:941-917-2095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS