Healthcare Provider Details

I. General information

NPI: 1073884441
Provider Name (Legal Business Name): RITA SHOUKRY PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2012
Last Update Date: 03/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8752 LOVAS TRAIL
TRINITY FL
34655
US

IV. Provider business mailing address

8752 LOVAS TRL
TRINITY FL
34655-5325
US

V. Phone/Fax

Practice location:
  • Phone: 727-505-9676
  • Fax:
Mailing address:
  • Phone: 727-505-9676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS48469
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: