Provider Demographics
NPI:1306848015
Name:TROCARD, KELVIN DEXTER (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:KELVIN
Middle Name:DEXTER
Last Name:TROCARD
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 1:2617 SW 130TH TER
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-3888
Mailing Address - Country:US
Mailing Address - Phone:786-466-1735
Mailing Address - Fax:
Practice Address - Street 1:16555 NW 25TH AVE
Practice Address - Street 2:
Practice Address - City:OPA LOCKA
Practice Address - State:FL
Practice Address - Zip Code:33054-6583
Practice Address - Country:US
Practice Address - Phone:786-466-1735
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 31377183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist