Provider Demographics
NPI:1104180983
Name:FLORENTINO, CECILLE (RPH)
Entity Type:Individual
Prefix:
First Name:CECILLE
Middle Name:
Last Name:FLORENTINO
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 1:3770 US HIGHWAY 395 S
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89705-6898
Mailing Address - Country:US
Mailing Address - Phone:775-267-2461
Mailing Address - Fax:775-267-5623
Practice Address - Street 1:3770 US HIGHWAY 395 S
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89705-6898
Practice Address - Country:US
Practice Address - Phone:775-267-2461
Practice Address - Fax:775-267-5623
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-27
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00007085183500000X
NV17612183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist