Healthcare Provider Details

I. General information

NPI: 1851678239
Provider Name (Legal Business Name): NAJA ECCLESTON PHARM. D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2011
Last Update Date: 11/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12801 W SUNRISE BLVD
SUNRISE FL
33323-4020
US

IV. Provider business mailing address

10183 SW 21ST ST
MIRAMAR FL
33025-6516
US

V. Phone/Fax

Practice location:
  • Phone: 954-846-0716
  • Fax:
Mailing address:
  • Phone: 754-204-8557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS48340
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: