Provider Demographics
NPI:1386928125
Name:ADDERLEY, TASHARA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TASHARA
Middle Name:
Last Name:ADDERLEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 NE 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-5608
Mailing Address - Country:US
Mailing Address - Phone:561-272-5523
Mailing Address - Fax:
Practice Address - Street 1:430 NE 6TH AVE
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-5608
Practice Address - Country:US
Practice Address - Phone:561-272-5523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS41927183500000X
MD18569183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist