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General NPI Number Information
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NPI Number | 1669945341
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Entity Type | Individual
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Provider Name | KAYLA LANAE CALLOWAY PHARMD
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Gender | Female
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Dates
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Enumeration Date | 01/06/2019
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Last Update Date | 12/28/2020
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Provider Practice Location Address
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Address Line | 1460 CORNERSTONE BLVD
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City | DAYTONA BEACH
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State | FL
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Zip | 32117
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Country | US
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Telephone | 386-760-3078
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Fax |
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Provider Business Mailing Address
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Address Line | 1460 CORNERSTONE BLVD
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City | DAYTONA BEACH
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State | FL
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Zip | 32117-7174
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Country | US
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Telephone | 386-760-3078
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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 | 2015023947
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS53744
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License Number State | FL
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