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General NPI Number Information
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NPI Number | 1114066107
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Entity Type | Individual
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Provider Name | ANNA MARIA QUINLEY PHARMD
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Gender | Female
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1189 JOHN SIMS PKWY E
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City | NICEVILLE
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State | FL
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Zip | 32578-2752
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Country | US
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Telephone | 850-729-3684
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Fax |
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Provider Business Mailing Address
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Address Line | 2395 CUMBERLAND WAY
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City | CRESTVIEW
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State | FL
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Zip | 32536
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Country | US
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Telephone | 850-689-2632
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS 41305
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License Number State | FL
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