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NPI Code Detail

MEDICARE: VICTORIA LOUISE EVELYN PHARMD

MEDICARE: VICTORIA LOUISE EVELYN PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPS37950FL

General Provider Information

NPI Number : 1154660629
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA LOUISE EVELYN PHARMD
Provider Business Mailing Address
First Line : 1000 DEER SPRING DR
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32221-2555
Country : US
Telephone Number : 904-327-0957
Fax Number : 904-378-0456
Provider Business Practice Location Address
First Line : 1000 DEER SPRING DR
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32221-2555
Country : US
Telephone Number : 904-327-0957
Fax Number : 904-378-0456
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2013
Last Update Date : 02/04/2013

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Directions to “ VICTORIA LOUISE EVELYN PHARMD” Practice Location

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