Individual
SHANNON BROOKE SEPULVEDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LM, LPN
Contact information
Practice address
710 SUMMER ST, WINTER GARDEN, FL 34787-4021
(321) 946-4499
Mailing address
9204 CHARLES E LIMPUS RD, ORLANDO, FL 32836-5806
(321) 946-4499
(407) 265-9788
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
PN5155859
FL
174H00000X
Health Educator
—
—
176B00000X
Midwife
Primary
MW371
FL
374J00000X
Doula
—
—
Other
Enumeration date
12/07/2012
Last updated
10/24/2018
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