Provider Demographics
NPI:1326332487
Name:GLAB, AGNIESZKA ANNA (PHARMD)
Entity Type:Individual
Prefix:
First Name:AGNIESZKA
Middle Name:ANNA
Last Name:GLAB
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 1:7150 US 19 N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-4602
Mailing Address - Country:US
Mailing Address - Phone:727-803-0023
Mailing Address - Fax:
Practice Address - Street 1:7150 US 19 N
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-4602
Practice Address - Country:US
Practice Address - Phone:727-803-0023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21415183500000X
FLPS56084183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist