Provider Demographics
NPI:1558919431
Name:LAFORTUNE, SUKI (PHARMD)
Entity Type:Individual
Prefix:
First Name:SUKI
Middle Name:
Last Name:LAFORTUNE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:SUKY
Other - Middle Name:
Other - Last Name:LAFORTUNE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:4946 SW 135TH TER
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-5929
Mailing Address - Country:US
Mailing Address - Phone:305-494-0808
Mailing Address - Fax:
Practice Address - Street 1:9400 NW 12TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33150-2025
Practice Address - Country:US
Practice Address - Phone:305-494-0808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-03
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS59904183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist