| Ohana Family Practice Llc | |
|
8255 N Wickham Rd Ste 100 Melbourne FL 32940-8202 | |
| (321) 473-6292 | |
| (321) 600-4246 |
| Full Name | Ohana Family Practice Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 8255 N Wickham Rd Ste 100, Melbourne, Florida |
| Authorized Official Name and Position | Katie Lou Shouppe (OWNER) |
| Authorized Official Contact | 3214736292 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ohana Family Practice Llc 8255 N Wickham Rd Ste 100 Melbourne FL 32940-8202 Ph: (321) 473-6292 | Ohana Family Practice Llc 8255 N Wickham Rd Ste 100 Melbourne FL 32940-8202 Ph: (321) 473-6292 |
| NPI Number | 1366210973 |
|---|---|
| Provider Enumeration Date | 12/13/2023 |
| Last Update Date | 12/13/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366210973 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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