Provider Demographics
NPI:1043557903
Name:HINES, REBECCA JAMES (RPH)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:JAMES
Last Name:HINES
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 1:852 GULF BREEZE PKWY
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32561-4723
Mailing Address - Country:US
Mailing Address - Phone:850-932-0030
Mailing Address - Fax:850-932-0043
Practice Address - Street 1:852 GULF BREEZE PKWY
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32561-4723
Practice Address - Country:US
Practice Address - Phone:850-932-0030
Practice Address - Fax:850-932-0043
Is Sole Proprietor?:No
Enumeration Date:2013-01-12
Last Update Date:2013-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS25848183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist