Provider Demographics
NPI:1699227199
Name:SHTERENVASER, JULIE C (PHARMD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:C
Last Name:SHTERENVASER
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 1:6451 APPALOOSA TRL
Mailing Address - Street 2:
Mailing Address - City:SW RANCHES
Mailing Address - State:FL
Mailing Address - Zip Code:33330-3809
Mailing Address - Country:US
Mailing Address - Phone:954-483-8126
Mailing Address - Fax:
Practice Address - Street 1:6451 APPALOOSA TRL
Practice Address - Street 2:
Practice Address - City:SW RANCHES
Practice Address - State:FL
Practice Address - Zip Code:33330-3809
Practice Address - Country:US
Practice Address - Phone:954-483-8126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-31
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS32770183500000X
WVRP0009223183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist