Provider Demographics
NPI:1083735120
Name:PUEL, ROMELIA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:ROMELIA
Middle Name:
Last Name:PUEL
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 1:9143 PHILIPS HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-1366
Mailing Address - Country:US
Mailing Address - Phone:904-363-3089
Mailing Address - Fax:
Practice Address - Street 1:9143 PHILIPS HWY STE 300
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-1366
Practice Address - Country:US
Practice Address - Phone:904-363-3089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS35570183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist