Provider Demographics
NPI:1437758158
Name:FROMETA, LEIBNIZ LAYRA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LEIBNIZ
Middle Name:LAYRA
Last Name:FROMETA
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 1:6701 N DALE MABRY HWY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-3926
Mailing Address - Country:US
Mailing Address - Phone:813-873-0472
Mailing Address - Fax:
Practice Address - Street 1:6701 N DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-3926
Practice Address - Country:US
Practice Address - Phone:813-873-0472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-23
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS59933183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist