Provider Demographics
NPI:1003646555
Name:SHEHU, ERILDA
Entity type:Individual
Prefix:
First Name:ERILDA
Middle Name:
Last Name:SHEHU
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 1:1390 N INDIANA ST
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-9206
Mailing Address - Country:US
Mailing Address - Phone:407-749-2050
Mailing Address - Fax:
Practice Address - Street 1:1390 N INDIANA ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-9206
Practice Address - Country:US
Practice Address - Phone:407-749-2050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS67440183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist