Healthcare Provider Details

I. General information

NPI: 1295676013
Provider Name (Legal Business Name): SHAWN WHITNEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2026
Last Update Date: 04/04/2026
Certification Date: 04/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 SE SALERNO RD
STUART FL
34997-6503
US

IV. Provider business mailing address

1584 SE DOMINION WAY
STUART FL
34997-7642
US

V. Phone/Fax

Practice location:
  • Phone: 772-223-6943
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS35710
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: