Provider Demographics
NPI:1144611146
Name:PRELLEZO, CHRISTOPHER (PHARM D)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:PRELLEZO
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1422 SW 147TH TER
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33027-6188
Mailing Address - Country:US
Mailing Address - Phone:305-281-9508
Mailing Address - Fax:
Practice Address - Street 1:2499 SW 101ST AVE
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-5082
Practice Address - Country:US
Practice Address - Phone:954-436-6247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-12
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS52749183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist