Provider Demographics
NPI:1245841568
Name:SOOMDAT, NATALIE SHARMELA (PHARMD)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:SHARMELA
Last Name:SOOMDAT
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 1:12220 86TH RD N
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33412-2657
Mailing Address - Country:US
Mailing Address - Phone:954-854-7310
Mailing Address - Fax:
Practice Address - Street 1:600 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6731
Practice Address - Country:US
Practice Address - Phone:954-433-4408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-11
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS61238183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist