Individual
RHONDA SHOUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1881 MADISON AVE, MELBOURNE, FL 32935-4045
(321) 544-9091
Mailing address
1881 MADISON AVE, MELBOURNE, FL 32935-4045
(321) 544-9091
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
FL
Other
Enumeration date
10/02/2019
Last updated
10/02/2019
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