MEDICARE: SHIVSANKAR MISIR RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PS31307	FL

General Provider Information

NPI Number	:	1780363069
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHIVSANKAR MISIR RPH

Provider Business Mailing Address
First Line	:	3260 SUNDANCE CIR
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34109-8923
Country	:	US
Telephone Number	:	239-821-0485
Fax Number	:

Provider Business Practice Location Address
First Line	:	8795 TAMIAMI TRL E # 201
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34113-3313
Country	:	US
Telephone Number	:	239-403-0060
Fax Number	:	239-403-0065

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2023
Last Update Date	:	07/14/2023

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Directions to “ SHIVSANKAR MISIR RPH” Practice Location

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