Healthcare Provider Details

I. General information

NPI: 1205749579
Provider Name (Legal Business Name): ASHLEY MISHOE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 OAKFIELD DR STE 115-3596
BRANDON FL
33511-4930
US

IV. Provider business mailing address

1111 OAKFIELD DR STE 115-3596
BRANDON FL
33511-4930
US

V. Phone/Fax

Practice location:
  • Phone: 843-421-4000
  • Fax:
Mailing address:
  • Phone: 843-421-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835N0905X
TaxonomyNuclear Pharmacist
License Number14098
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: