Provider Demographics
NPI:1003113069
Name:WATSON, TOYKA S
Entity Type:Individual
Prefix:MRS
First Name:TOYKA
Middle Name:S
Last Name:WATSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TOYKA
Other - Middle Name:S
Other - Last Name:MUNGEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3263 NEWBERRY BLVD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32311-3716
Mailing Address - Country:US
Mailing Address - Phone:850-766-7056
Mailing Address - Fax:
Practice Address - Street 1:3263 NEWBERRY BLVD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32311-3716
Practice Address - Country:US
Practice Address - Phone:850-766-7056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-26
Last Update Date:2011-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0025934183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist