Provider Demographics
NPI:1275919391
Name:DAVIS, SHAMARA ARIEL (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:SHAMARA
Middle Name:ARIEL
Last Name:DAVIS
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 1:10005 NW 83RD ST APT 3
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-1283
Mailing Address - Country:US
Mailing Address - Phone:954-990-9584
Mailing Address - Fax:
Practice Address - Street 1:10005 NW 83RD ST APT 3
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-1283
Practice Address - Country:US
Practice Address - Phone:954-990-9584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-31
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS53749183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist