Provider Demographics
NPI:1477848620
Name:SHAH, ROSHNI (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ROSHNI
Middle Name:
Last Name:SHAH
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 1:187 BRANDON TOWN CENTER DR
Mailing Address - Street 2:T0812
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-4754
Mailing Address - Country:US
Mailing Address - Phone:813-654-4843
Mailing Address - Fax:813-654-4843
Practice Address - Street 1:187 BRANDON TOWN CENTER DR
Practice Address - Street 2:T0812
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-4754
Practice Address - Country:US
Practice Address - Phone:813-654-4843
Practice Address - Fax:813-654-4843
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS45338183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist