Provider Demographics
NPI:1144372962
Name:KAZMER, JOSEPH (RPH)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:KAZMER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 FLORIDA WAY
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-8512
Mailing Address - Country:US
Mailing Address - Phone:772-878-2079
Mailing Address - Fax:
Practice Address - Street 1:14 FLORIDA WAY
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-8512
Practice Address - Country:US
Practice Address - Phone:772-878-2079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS-0014541183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist