Provider Demographics
NPI:1346630464
Name:LUZAR, ERIC (PHARMD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:LUZAR
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 1:6257 N US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:PORT ST JOHN
Mailing Address - State:FL
Mailing Address - Zip Code:32927-4925
Mailing Address - Country:US
Mailing Address - Phone:321-633-8150
Mailing Address - Fax:321-633-6880
Practice Address - Street 1:6257 N US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:PORT ST JOHN
Practice Address - State:FL
Practice Address - Zip Code:32927-4925
Practice Address - Country:US
Practice Address - Phone:321-633-8150
Practice Address - Fax:321-633-6880
Is Sole Proprietor?:No
Enumeration Date:2015-01-27
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS35202183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS35202OtherPHARMACIST LICENSE NUMBER