Provider Demographics
NPI:1558494625
Name:SHOUPPE, APRIL NIKOLE I
Entity type:Individual
Prefix:MISS
First Name:APRIL
Middle Name:NIKOLE
Last Name:SHOUPPE
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1814
Mailing Address - Street 2:
Mailing Address - City:AUBURNDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33823-1814
Mailing Address - Country:US
Mailing Address - Phone:863-669-6050
Mailing Address - Fax:
Practice Address - Street 1:107 WILLIS ST
Practice Address - Street 2:
Practice Address - City:AUBURNDALE
Practice Address - State:FL
Practice Address - Zip Code:33823-3826
Practice Address - Country:US
Practice Address - Phone:863-669-6050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 45616225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist