Provider Demographics
NPI:1033712138
Name:CARRANZA, ROSALIN A (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ROSALIN
Middle Name:A
Last Name:CARRANZA
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 3RD ST
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-2359
Mailing Address - Country:US
Mailing Address - Phone:352-638-1470
Mailing Address - Fax:
Practice Address - Street 1:3343 DANIELS RD
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-7009
Practice Address - Country:US
Practice Address - Phone:407-395-0112
Practice Address - Fax:407-395-0122
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS59721333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy