Provider Demographics
NPI:1265484778
Name:SCHNACKY, KIMBERLY ROXANNE (PHARMD, BCPS)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:ROXANNE
Last Name:SCHNACKY
Suffix:
Gender:F
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7015 BRAMLEA LN
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-6624
Mailing Address - Country:US
Mailing Address - Phone:407-905-9756
Mailing Address - Fax:321-397-6113
Practice Address - Street 1:5201 RAYMOND ST
Practice Address - Street 2:ORLANDO VA HEALTHCARE CENTER
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-8208
Practice Address - Country:US
Practice Address - Phone:407-599-1378
Practice Address - Fax:321-397-6113
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 00330711835P1200X
FLPS00330711835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist