Provider Demographics
NPI:1194031997
Name:CAMERON, HEATHER MARY (RPH)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:MARY
Last Name:CAMERON
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 1:3801 CORPOREX PARK DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-1183
Mailing Address - Country:US
Mailing Address - Phone:908-389-1818
Mailing Address - Fax:
Practice Address - Street 1:3801 CORPOREX PARK DR
Practice Address - Street 2:SUITE 100
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-1183
Practice Address - Country:US
Practice Address - Phone:908-389-1818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-31
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 417281835G0303X
NJ28RI023424001835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric