Provider Demographics
NPI:1437586500
Name:PERKINS, ALYCE MILDRED (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ALYCE
Middle Name:MILDRED
Last Name:PERKINS
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 1:2301 STATE ROAD 524
Mailing Address - Street 2:SUITE 150
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32922
Mailing Address - Country:US
Mailing Address - Phone:321-636-2583
Mailing Address - Fax:
Practice Address - Street 1:2301 STATE ROAD 524
Practice Address - Street 2:SUITE 150
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32922
Practice Address - Country:US
Practice Address - Phone:321-636-2583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 50624183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist