Individual
JANICE M CHUPKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
315 E OLYMPIA AVE UNIT 111, PUNTA GORDA, FL 33950-3823
(941) 639-1640
(941) 637-9808
Mailing address
2675 WINKLER AVE FL 2, FORT MYERS, FL 33901-9342
(877) 856-3774
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110001379
VA
363A00000X
Physician Assistant
Primary
PA9108642
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750316311
—
VA
Enumeration date
07/12/2006
Last updated
01/16/2025
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