MR. Jonathan Peter Shade, OT

NPI #1740658202 in Apopka, Florida

Provider Information

NPI Number: 1740658202
Entity Type: Individual
Name: MR. Jonathan Peter Shade, OT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Occupational Therapist
Credential: OT
Enumeration Date: Sep 14, 2015
Last Updated: Sep 14, 2015

Practice Location

Address: 1509 W ORANGE BLOSSOM TRL
City: Apopka
State: Florida
ZIP Code: 32712-2640
Phone: (407) 814-0436

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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