Individual
DR. JARED ANDREW SHENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1400 S ORANGE AVE, ORLANDO, FL 32806-2134
(321) 841-6965
(321) 843-6975
Mailing address
1400 S ORANGE AVE, ORLANDO, FL 32806-2134
(321) 841-6965
(321) 843-6975
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
ME157087
FL
207Y00000X
Otolaryngology Physician
S8914
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
426240401
—
TX
01
—
426240402
CSHCN MEDICAID TPI
TX
Enumeration date
04/18/2016
Last updated
08/17/2022
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