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General NPI Number Information
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NPI Number | 1811013667
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Entity Type | Individual
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Provider Name | LORRAINE N KEITES RPH
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Gender | Female
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 126 POINT LOUISA RD
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City | HAWTHORNE
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State | FL
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Zip | 32640-5541
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Country | US
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Telephone | 352-481-4521
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Fax | 352-481-3801
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Provider Business Mailing Address
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Address Line | PO BOX 886
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City | HAWTHORNE
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State | FL
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Zip | 32640-0886
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Country | US
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Telephone | 352-481-4521
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Fax | 352-481-3801
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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 | PS14220
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License Number State | FL
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