Healthcare Provider Details

I. General information

NPI: 1699442871
Provider Name (Legal Business Name): ASHANI MCDONALD PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2021
Last Update Date: 08/25/2021
Certification Date: 08/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1302 RIVER ST
PALATKA FL
32177-5042
US

IV. Provider business mailing address

16233 SW 107TH PL
MIAMI FL
33157-2967
US

V. Phone/Fax

Practice location:
  • Phone: 386-328-0558
  • Fax:
Mailing address:
  • Phone: 305-542-0990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS63063
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: