Healthcare Provider Details

I. General information

NPI: 1104087733
Provider Name (Legal Business Name): DON REEDER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2008
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 SW ARCHER RD
GAINESVILLE FL
32608-1135
US

IV. Provider business mailing address

3229 NW 24TH AVE
GAINESVILLE FL
32605-2758
US

V. Phone/Fax

Practice location:
  • Phone: 352-374-6113
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS43566
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: