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General NPI Number Information
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NPI Number | 1912414988
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Entity Type | Individual
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Provider Name | SHANNON ACOSTA-BARNES
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Gender | Female
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Dates
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Enumeration Date | 12/29/2017
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Last Update Date | 12/29/2017
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Provider Practice Location Address
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Address Line | 6251 PGA BLVD
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33418-4000
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Country | US
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Telephone | 561-624-0234
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Fax |
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Provider Business Mailing Address
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Address Line | 15874 FISHHAWK VIEW DR
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City | LITHIA
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State | FL
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Zip | 33547-3861
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Country | US
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Telephone |
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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 | PS56628
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License Number State | FL
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