Provider Demographics
NPI:1073125530
Name:LACEY, DEBREAH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DEBREAH
Middle Name:
Last Name:LACEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6015 SW HIGHWAY 200
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34476-5557
Mailing Address - Country:US
Mailing Address - Phone:352-291-9435
Mailing Address - Fax:352-291-9432
Practice Address - Street 1:6015 SW HIGHWAY 200
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34476-5557
Practice Address - Country:US
Practice Address - Phone:352-291-9435
Practice Address - Fax:352-291-9432
Is Sole Proprietor?:No
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS58633183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist