Provider Demographics
NPI:1275164576
Name:ORR, SHENJIN (PHARM D)
Entity Type:Individual
Prefix:
First Name:SHENJIN
Middle Name:
Last Name:ORR
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6313 WILD ORCHID DR
Mailing Address - Street 2:
Mailing Address - City:LITHIA
Mailing Address - State:FL
Mailing Address - Zip Code:33547-5043
Mailing Address - Country:US
Mailing Address - Phone:813-525-1499
Mailing Address - Fax:
Practice Address - Street 1:6313 WILD ORCHID DR
Practice Address - Street 2:
Practice Address - City:LITHIA
Practice Address - State:FL
Practice Address - Zip Code:33547-5043
Practice Address - Country:US
Practice Address - Phone:813-525-1499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-27
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS42757183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist