Provider Demographics
NPI:1114010493
Name:KIDD, PATRICIA GENE (RPH)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:GENE
Last Name:KIDD
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 1:6044 CAULK CT
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32163-0456
Mailing Address - Country:US
Mailing Address - Phone:352-613-0655
Mailing Address - Fax:
Practice Address - Street 1:2449 E SILVER SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-6908
Practice Address - Country:US
Practice Address - Phone:352-401-9492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-01
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS37887183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist