Healthcare Provider Details

I. General information

NPI: 1356837686
Provider Name (Legal Business Name): RODSHEKA CRITTENDEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2018
Last Update Date: 07/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 MAGUIRE RD
OCOEE FL
34761-4752
US

IV. Provider business mailing address

3312 MCCORMICK WOODS DR
OCOEE FL
34761-4443
US

V. Phone/Fax

Practice location:
  • Phone: 407-656-8537
  • Fax:
Mailing address:
  • Phone: 310-770-6974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS46766
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: