Provider Demographics
NPI:1558991166
Name:PASSLEY, SHEWANA K (PHARMD)
Entity Type:Individual
Prefix:
First Name:SHEWANA
Middle Name:K
Last Name:PASSLEY
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 1:6222 NAVAJO TER
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-8351
Mailing Address - Country:US
Mailing Address - Phone:305-409-3839
Mailing Address - Fax:
Practice Address - Street 1:6222 NAVAJO TER
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-8351
Practice Address - Country:US
Practice Address - Phone:305-409-3839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS60144183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist