Provider Demographics
NPI:1023387818
Name:JAFFER-BRUCE, ROZINA HAIDER
Entity Type:Individual
Prefix:
First Name:ROZINA
Middle Name:HAIDER
Last Name:JAFFER-BRUCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 N NORMANDY BLVD
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32725
Mailing Address - Country:US
Mailing Address - Phone:386-532-4048
Mailing Address - Fax:386-532-4054
Practice Address - Street 1:1700 N NORMANDY BLVD
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32725
Practice Address - Country:US
Practice Address - Phone:386-532-4048
Practice Address - Fax:386-532-4054
Is Sole Proprietor?:No
Enumeration Date:2011-12-22
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS42048183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL026643400Medicaid