Healthcare Provider Details

I. General information

NPI: 1710809140
Provider Name (Legal Business Name): KORTNEY MEARS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8101 W SUNRISE BLVD
PLANTATION FL
33322-5401
US

IV. Provider business mailing address

9335 NW 9TH PL
PLANTATION FL
33324-6149
US

V. Phone/Fax

Practice location:
  • Phone: 954-473-9255
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number70330
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: