Provider Demographics
NPI:1275871816
Name:STOCKER, EDWARD C (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:C
Last Name:STOCKER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 BAYSIDE LAKES BLVD SE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32909-6815
Mailing Address - Country:US
Mailing Address - Phone:321-725-3757
Mailing Address - Fax:321-725-5881
Practice Address - Street 1:3450 BAYSIDE LAKES BLVD SE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32909-6815
Practice Address - Country:US
Practice Address - Phone:321-725-3757
Practice Address - Fax:321-725-5881
Is Sole Proprietor?:No
Enumeration Date:2013-01-16
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS35425183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist