Provider Demographics
NPI:1023394525
Name:MORANCY-CALDERON, VALANTINA BERNADETTE (RPH, BCMTMS, CPH)
Entity Type:Individual
Prefix:DR
First Name:VALANTINA
Middle Name:BERNADETTE
Last Name:MORANCY-CALDERON
Suffix:
Gender:F
Credentials:RPH, BCMTMS, CPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 SW GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-1025
Mailing Address - Country:US
Mailing Address - Phone:305-528-6539
Mailing Address - Fax:
Practice Address - Street 1:1125 DOUGLASS AVE
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3228
Practice Address - Country:US
Practice Address - Phone:561-319-5634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-27
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPU88351835P0018X
FLPS481731835P1200X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy