Provider Demographics
NPI:1003411943
Name:CAMPBELL, MIRUNA (PHARM D)
Entity Type:Individual
Prefix:
First Name:MIRUNA
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:MIRUNA
Other - Middle Name:
Other - Last Name:MOISOIU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9824 S MILITARY TRL
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-3201
Mailing Address - Country:US
Mailing Address - Phone:954-995-3549
Mailing Address - Fax:561-732-5216
Practice Address - Street 1:9824 S MILITARY TRL
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-3201
Practice Address - Country:US
Practice Address - Phone:561-732-9115
Practice Address - Fax:561-732-5216
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS52824183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist