Provider Demographics
NPI:1861427981
Name:POITIER, SHARAVON M (RPH)
Entity type:Individual
Prefix:MS
First Name:SHARAVON
Middle Name:M
Last Name:POITIER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:332 SW 10TH CT
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-6513
Mailing Address - Country:US
Mailing Address - Phone:954-421-4178
Mailing Address - Fax:
Practice Address - Street 1:5317 W ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-8175
Practice Address - Country:US
Practice Address - Phone:561-496-6032
Practice Address - Fax:561-637-4944
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS15747183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist