Provider Demographics
NPI:1922433077
Name:SHIWRAM, PEARL ANN ARRITA
Entity Type:Individual
Prefix:
First Name:PEARL
Middle Name:ANN ARRITA
Last Name:SHIWRAM
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 1:962 NANCY CT
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34759-3802
Mailing Address - Country:US
Mailing Address - Phone:407-346-8686
Mailing Address - Fax:407-483-4768
Practice Address - Street 1:703 ANTELOPE WAY
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759
Practice Address - Country:US
Practice Address - Phone:407-346-8686
Practice Address - Fax:863-353-1126
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-09
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL64061013004246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy