Individual
JACQUELINE SHOLOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
4145 NW 53RD AVE, GAINESVILLE, FL 32653-4404
(352) 371-9329
Mailing address
7546 SW 28TH ST, DAVIE, FL 33314-1007
(561) 843-5387
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PS55966
FL
Other
Enumeration date
12/09/2020
Last updated
12/09/2020
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