Provider Demographics
NPI:1124403985
Name:GILZENE, TENILLE (PHARMD)
Entity Type:Individual
Prefix:
First Name:TENILLE
Middle Name:
Last Name:GILZENE
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 1:520 BORDEAUX ST
Mailing Address - Street 2:APT 2
Mailing Address - City:CHADRON
Mailing Address - State:NE
Mailing Address - Zip Code:69337-2975
Mailing Address - Country:US
Mailing Address - Phone:954-684-3994
Mailing Address - Fax:
Practice Address - Street 1:3760 INVERRARY DR
Practice Address - Street 2:APT 2E
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33319-5125
Practice Address - Country:US
Practice Address - Phone:954-684-3994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-22
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS497881835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist