Provider Demographics
NPI:1093838641
Name:WERTZ, DEBORAH M (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:M
Last Name:WERTZ
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 1:101 N BLAIRSTONE RD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-2877
Mailing Address - Country:US
Mailing Address - Phone:850-219-6221
Mailing Address - Fax:850-219-6393
Practice Address - Street 1:101 N BLAIRSTONE RD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-2877
Practice Address - Country:US
Practice Address - Phone:850-219-6221
Practice Address - Fax:850-219-6393
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS35138183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist