Provider Demographics
NPI:1760958417
Name:ROBINSON, SHAUNA PATRICE
Entity Type:Individual
Prefix:DR
First Name:SHAUNA
Middle Name:PATRICE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7320 NW 1ST CT
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2257
Mailing Address - Country:US
Mailing Address - Phone:954-895-2541
Mailing Address - Fax:
Practice Address - Street 1:7320 NW 1ST CT
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2257
Practice Address - Country:US
Practice Address - Phone:954-895-2541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-21
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA0023551183500000X
FLPS62897183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist