SHANE A LIVENSPARGER
Medical Practice at Ponte Vedra Lk Blvd, Ponte Vedra, FL

License number
Florida 511304
Issued Date
Oct 6, 2005
Effective Date
Jun 15, 2013
Expiration Date
Dec 1, 2012
Category
Health Care
Type
Emergency Medical Technician
Address
Address 2
611 Ponte Vedra Lakes Blvd UNIT 1108, Ponte Vedra, FL 32082
901 Pope Rd, Saint Augustine, FL 32080
Phone
(904) 673-6219
LicenseFiles verified this license of Jun 1, 2017 at the Health Care Practitioner Data Portal.

Personal information

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Name
Address
Phone
Shane Livensparger
18 Valencia St, Saint Augustine, FL 32084
(904) 829-9548

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