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General NPI Number Information
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NPI Number | 1063805588
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Entity Type | Individual
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Provider Name | FARZANA SHADAB RPH
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Gender | Female
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Dates
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Enumeration Date | 03/09/2015
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Last Update Date | 03/09/2015
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Provider Practice Location Address
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Address Line | 10665 BIG BEND RD
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City | RIVERVIEW
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State | FL
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Zip | 33579-7176
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Country | US
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Telephone | 813-234-3216
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Fax | 813-234-3264
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Provider Business Mailing Address
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Address Line | 5828 TULIP FLOWER DR
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City | RIVERVIEW
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State | FL
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Zip | 33578-3735
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Country | US
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Telephone | 813-523-8587
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS42293
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License Number State | FL
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