Individual
SHELIA MARIE LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3622 FALLING LEAF LN, ORLANDO, FL 32810-2270
(407) 766-3612
Mailing address
3622 FALLING LEAF LN, ORLANDO, FL 32810-2270
(407) 766-3612
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
PS45188
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1699154161
PHARMACY
FL
Enumeration date
03/23/2021
Last updated
03/23/2021
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