Individual
SIMEON SHEPARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13238 ROYAL GEORGE AVE, ODESSA, FL 33556
(386) 566-1949
Mailing address
13238 ROYAL GEORGE AVE, ODESSA, FL 33556-5724
(386) 566-1949
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
119725
FL
Other
Enumeration date
08/28/2017
Last updated
07/21/2022
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