Individual
JARED ANDREW SHOUPPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5145 DEER PARK DR, NEW PORT RICHEY, FL 34653-7013
(727) 848-1417
Mailing address
31 ISLAND WAY APT 1508, CLEARWATER, FL 33767-2211
(850) 509-2707
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
PA9115257
FL
Other
Enumeration date
10/28/2021
Last updated
10/28/2021
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