Provider Demographics
NPI:1417418542
Name:LAFFERTY, INGA (PHARMD)
Entity Type:Individual
Prefix:
First Name:INGA
Middle Name:
Last Name:LAFFERTY
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 1:22237 COLLINGTON DR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-4725
Mailing Address - Country:US
Mailing Address - Phone:561-479-8724
Mailing Address - Fax:
Practice Address - Street 1:4650 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-4626
Practice Address - Country:US
Practice Address - Phone:954-753-7181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-29
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS42787333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy