Healthcare Provider Details

I. General information

NPI: 1235481482
Provider Name (Legal Business Name): MARGARETTA L KEARSON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2012
Last Update Date: 10/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 JOHNSON ST
HOLLYWOOD FL
33021-5421
US

IV. Provider business mailing address

14660 SW 39TH CT
MIRAMAR FL
33027-3721
US

V. Phone/Fax

Practice location:
  • Phone: 954-265-5505
  • Fax: 954-986-5408
Mailing address:
  • Phone: 954-704-8408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPS30706
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPU6031
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: