Provider Demographics
NPI:1265036404
Name:GROSS, SOFIA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SOFIA
Middle Name:
Last Name:GROSS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10004 W MCNAB RD
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-1815
Mailing Address - Country:US
Mailing Address - Phone:954-558-6732
Mailing Address - Fax:
Practice Address - Street 1:10004 W MCNAB RD
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-1815
Practice Address - Country:US
Practice Address - Phone:954-718-5095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-29
Last Update Date:2020-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS58173183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist