Provider Demographics
NPI:1184301012
Name:PUPO, SHELBY CATHERINE (MED)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:CATHERINE
Last Name:PUPO
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13652 ERIDANUS DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-9370
Mailing Address - Country:US
Mailing Address - Phone:407-451-8022
Mailing Address - Fax:
Practice Address - Street 1:935 175TH ST STE 307
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-2073
Practice Address - Country:US
Practice Address - Phone:773-888-9830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health