Provider Demographics
NPI:1356509525
Name:MOHAMED, SHAWN (PHARM D)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:
Last Name:MOHAMED
Suffix:
Gender:M
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 1:7920 NW 6TH ST
Mailing Address - Street 2:# 205
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-5186
Mailing Address - Country:US
Mailing Address - Phone:954-962-8088
Mailing Address - Fax:
Practice Address - Street 1:70 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6730
Practice Address - Country:US
Practice Address - Phone:954-432-5510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-24
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS44014183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist