Provider Demographics
NPI:1952465692
Name:SHERWIN, DOUGLAS A (MS, RPH)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:A
Last Name:SHERWIN
Suffix:
Gender:M
Credentials:MS, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15102 KESTRELRISE DR
Mailing Address - Street 2:
Mailing Address - City:LITHIA
Mailing Address - State:FL
Mailing Address - Zip Code:33547-4832
Mailing Address - Country:US
Mailing Address - Phone:813-685-8181
Mailing Address - Fax:
Practice Address - Street 1:12902 MAGNOLIA DRIVE
Practice Address - Street 2:DEPARTMENT OF PHARMACY
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-9416
Practice Address - Country:US
Practice Address - Phone:813-979-3080
Practice Address - Fax:813-979-3994
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS28960183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist