Healthcare Provider Details

I. General information

NPI: 1831866714
Provider Name (Legal Business Name): KAYLA MARIE ECKER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2021
Last Update Date: 12/21/2023
Certification Date: 12/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1302 RIVER ST
PALATKA FL
32177-5042
US

IV. Provider business mailing address

306 UNION AVE
CRESCENT CITY FL
32112-4432
US

V. Phone/Fax

Practice location:
  • Phone: 386-328-8371
  • Fax:
Mailing address:
  • Phone: 386-698-2368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number63066
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: