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1740658202
JONATHAN PETER SHADE
APOPKA, FL
NPI
1740658202
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: FL OT1641)
Enumeration Date
2015-09-14
Last Update Date
2015-09-14
Business Address
Mr. JONATHAN PETER SHADE OT
1509 W ORANGE BLOSSOM TRL
APOPKA, FL 32712-2640
Phone number: 407-814-0436
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Mailing Address
Mr. JONATHAN PETER SHADE OT
585 PRESTON RD
LONGWOOD, FL 32750-3945
Phone number: 407-814-0436
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