Provider Demographics
NPI:1841332806
Name:SHEPPARD, DANIEL DAYON (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:DAYON
Last Name:SHEPPARD
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3793 HIGHWAY 4
Mailing Address - Street 2:PO BOX 575
Mailing Address - City:JAY
Mailing Address - State:FL
Mailing Address - Zip Code:32565-1756
Mailing Address - Country:US
Mailing Address - Phone:850-675-6990
Mailing Address - Fax:850-675-8051
Practice Address - Street 1:3793 HIGHWAY 4
Practice Address - Street 2:
Practice Address - City:JAY
Practice Address - State:FL
Practice Address - Zip Code:32565-1756
Practice Address - Country:US
Practice Address - Phone:850-675-6990
Practice Address - Fax:850-675-8051
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS324801835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy