Healthcare Provider Details

I. General information

NPI: 1437238813
Provider Name (Legal Business Name): KIMBERLY JO POLLARD PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIMBERLY JO CRYTZER PHARMD

II. Dates (important events)

Enumeration Date: 11/04/2006
Last Update Date: 01/06/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2489 DIPLOMAT PKWY. E. OUTPATIENT PHARMACY
CAPE CORAL FL
33909
US

IV. Provider business mailing address

2489 DIPLOMAT PKWY. E. OUTPATIENT PHARMACY
CAPE CORAL FL
33909
US

V. Phone/Fax

Practice location:
  • Phone: 239-652-1800
  • Fax: 239-652-1940
Mailing address:
  • Phone: 239-652-1800
  • Fax: 239-652-1940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS36793
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: