Provider Demographics
NPI:1124538632
Name:NERONI, CINDY I
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:NERONI
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9430 W MARIPOSA GRANDE
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-1143
Mailing Address - Country:US
Mailing Address - Phone:480-993-7579
Mailing Address - Fax:
Practice Address - Street 1:15442 N 99TH AVE
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-1962
Practice Address - Country:US
Practice Address - Phone:623-974-2526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-10
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS022796183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist