Individual
MRS. SANDRA L SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1222 S ORANGE AVE, ORLANDO, FL 32806-1215
(407) 351-5384
(407) 445-0321
Mailing address
1222 S ORANGE AVE, ORLANDO, FL 32806-1215
(407) 351-5384
(407) 445-0321
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9101579
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014944400
—
FL
01
—
PA9101579
MEDICAL LICENSE
FL
Enumeration date
06/07/2006
Last updated
11/14/2016
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