Healthcare Provider Details

I. General information

NPI: 1336074251
Provider Name (Legal Business Name): PATRICK LEFFERS PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2026
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

967 EAGLE POINT DR
SAINT AUGUSTINE FL
32092-5009
US

IV. Provider business mailing address

967 EAGLE POINT DR
SAINT AUGUSTINE FL
32092-5009
US

V. Phone/Fax

Practice location:
  • Phone: 904-427-0133
  • Fax:
Mailing address:
  • Phone: 904-427-0133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835E0208X
TaxonomyEmergency Medicine Pharmacist
License NumberPS53355
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: