Provider Demographics
NPI:1033704879
Name:O'BRIEN, CHRIS (R PH)
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:
Last Name:O'BRIEN
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 TINA MARIA CIR
Mailing Address - Street 2:
Mailing Address - City:PONCE INLET
Mailing Address - State:FL
Mailing Address - Zip Code:32127-7029
Mailing Address - Country:US
Mailing Address - Phone:868-438-3173
Mailing Address - Fax:
Practice Address - Street 1:36 TINA MARIA CIR
Practice Address - Street 2:
Practice Address - City:PONCE INLET
Practice Address - State:FL
Practice Address - Zip Code:32127-7029
Practice Address - Country:US
Practice Address - Phone:386-843-8317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS259451835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist