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NPI Code Detail

MEDICARE: DR. CORALIE ANDREE GRIFFIN PHARMD

MEDICARE: DR. CORALIE ANDREE GRIFFIN 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
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistPS 45677FL

General Provider Information

NPI Number : 1629161203
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CORALIE ANDREE GRIFFIN PHARMD
Provider Business Mailing Address
First Line : 7305 N MILITARY TRL
Second Line :
City : RIVIERA BEACH
State : FL
Zip : 33410-7417
Country : US
Telephone Number : 561-422-7782
Fax Number :
Provider Business Practice Location Address
First Line : 7503 N, MILITARY TRL
Second Line :
City : RIVIERA BEACH
State : FL
Zip : 33410
Country : US
Telephone Number : 561-422-8262
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2006
Last Update Date : 10/29/2010

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