MEDICARE: MRS. KRISTEN ELIZABETH ROLLINS PHARM. D

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
1	183500000X	Pharmacist	PS50330	FL

General Provider Information

NPI Number	:	1790123511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KRISTEN ELIZABETH ROLLINS PHARM. D

Provider Business Mailing Address
First Line	:	3786 NW 27TH ST
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32605-2074
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1120 E UNIVERSITY AVE
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32641-5614
Country	:	US
Telephone Number	:	352-380-0131
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2013
Last Update Date	:	06/14/2013

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