Individual
JORDAN SHOEMAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1970 GOLF ST, SARASOTA, FL 34236-6908
(941) 957-1000
(941) 951-2117
Mailing address
PO BOX 102222, ATLANTA, GA 30368-2222
(239) 274-8200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9118835
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122987900
—
FL
Enumeration date
05/28/2024
Last updated
07/18/2024
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