Provider Demographics
NPI:1326386707
Name:PACE, SHARON L (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:L
Last Name:PACE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 SW DUSTY GLN
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32024-3766
Mailing Address - Country:US
Mailing Address - Phone:386-752-7908
Mailing Address - Fax:
Practice Address - Street 1:255 NW COMMONS LOOP
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32055-7700
Practice Address - Country:US
Practice Address - Phone:386-719-5451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-20
Last Update Date:2013-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS20992183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist