Individual
JACQUELINE MARIE SHUPLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2501 N ORANGE AVE STE 310, ORLANDO, FL 32804-4642
(407) 303-2001
(407) 303-2450
Mailing address
2501 N ORANGE AVE STE 310, ORLANDO, FL 32804-4642
(407) 303-2001
(407) 303-2450
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
MD0000053338
TN
2080P0202X
Pediatric Cardiology Physician
Primary
ME152200
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/14/2012
Last updated
01/19/2022
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