Provider Demographics
NPI:1093279531
Name:GABISON, JOANNA ALEXANDRA (PHARMD)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:ALEXANDRA
Last Name:GABISON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:ALEXANDRA
Other - Last Name:ISIDRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:790 VETERANS WAY
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32507-1000
Mailing Address - Country:US
Mailing Address - Phone:508-912-2000
Mailing Address - Fax:
Practice Address - Street 1:790 VETERANS WAY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32507-1000
Practice Address - Country:US
Practice Address - Phone:850-912-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-29
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS569331835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory CareGroup - Single Specialty