Provider Demographics
NPI:1275802431
Name:METZGER, ENEIDA J (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ENEIDA
Middle Name:J
Last Name:METZGER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7003 PRESIDENTS DR
Mailing Address - Street 2:SUITE 250
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-5517
Mailing Address - Country:US
Mailing Address - Phone:407-859-6197
Mailing Address - Fax:
Practice Address - Street 1:4578 S KIRKMAN RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32811-2848
Practice Address - Country:US
Practice Address - Phone:407-293-8458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-17
Last Update Date:2011-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS44150183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS44150OtherPHARMACY LICENSE