Provider Demographics
NPI:1376264440
Name:COOLEY, EDEN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:EDEN
Middle Name:
Last Name:COOLEY
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 1:5320 S WEST SHORE BLVD UNIT 1402
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33611-5682
Mailing Address - Country:US
Mailing Address - Phone:407-694-2557
Mailing Address - Fax:
Practice Address - Street 1:3838 BRITTON PLZ
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33611-1406
Practice Address - Country:US
Practice Address - Phone:813-831-0856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS61848183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist