Provider Demographics
NPI:1275529133
Name:ASTLE, ELIZABETH D (CPH)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:D
Last Name:ASTLE
Suffix:
Gender:F
Credentials:CPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 SPARKLING CT
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-2354
Mailing Address - Country:US
Mailing Address - Phone:727-784-4447
Mailing Address - Fax:727-784-4448
Practice Address - Street 1:1611 SPARKLING CT
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-2354
Practice Address - Country:US
Practice Address - Phone:727-784-4447
Practice Address - Fax:727-784-4448
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 22381183500000X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy