Healthcare Provider Details

I. General information

NPI: 1649263732
Provider Name (Legal Business Name): RUTHAN ROBBIRDS WHITE PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 CELEBRATION PL
CELEBRATION FL
34747-4970
US

IV. Provider business mailing address

1952 LAZY OAKS LOOP
SAINT CLOUD FL
34771-8854
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-4061
  • Fax: 407-303-4519
Mailing address:
  • Phone: 352-359-5437
  • Fax: 407-303-4519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS38732
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: