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Organization
OHANA FAMILY PRACTICE LLC
Active
Organization
OHANA FAMILY PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATIE LOU SHOUPPE APRN (OWNER)
(321) 473-6292
Entity
Organization
Contact information
Practice address
8255 N WICKHAM RD STE 100, MELBOURNE, FL 32940-8202
(321) 473-6292
(321) 600-4246
Mailing address
8255 N WICKHAM RD STE 100, MELBOURNE, FL 32940-8202
(321) 473-6292
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
12/13/2023
Last updated
12/13/2023
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