Provider Demographics
NPI:1275871626
Name:MARSHALL, ALBERT PATRICK (RPH)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:PATRICK
Last Name:MARSHALL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2125 E COUNTY ROAD 540A
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-3794
Mailing Address - Country:US
Mailing Address - Phone:863-619-8332
Mailing Address - Fax:863-619-7993
Practice Address - Street 1:2125 E COUNTY ROAD 540A
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-3794
Practice Address - Country:US
Practice Address - Phone:863-619-8332
Practice Address - Fax:863-619-7993
Is Sole Proprietor?:No
Enumeration Date:2013-01-18
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS18458183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist