Provider Demographics
NPI:1013569383
Name:DEE, SYLVIA RAYE (RPH)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:RAYE
Last Name:DEE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4511 MISTY LN
Mailing Address - Street 2:
Mailing Address - City:LYNN HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:32444-3474
Mailing Address - Country:US
Mailing Address - Phone:850-625-2245
Mailing Address - Fax:
Practice Address - Street 1:4511 MISTY LN
Practice Address - Street 2:
Practice Address - City:LYNN HAVEN
Practice Address - State:FL
Practice Address - Zip Code:32444-3474
Practice Address - Country:US
Practice Address - Phone:850-625-2245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS116603336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy