Provider Demographics
NPI:1437406451
Name:HORACE, SHANNA NICOLE (BS, PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SHANNA
Middle Name:NICOLE
Last Name:HORACE
Suffix:
Gender:F
Credentials:BS, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:187 BRANDON TOWN CENTER DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-4754
Mailing Address - Country:US
Mailing Address - Phone:813-654-4843
Mailing Address - Fax:
Practice Address - Street 1:187 BRANDON TOWN CENTER DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-4754
Practice Address - Country:US
Practice Address - Phone:813-654-4843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-09
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS49438183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist