Provider Demographics
NPI:1447379433
Name:DEJESUS, EUFEMIA (BSPH)
Entity Type:Individual
Prefix:MS
First Name:EUFEMIA
Middle Name:
Last Name:DEJESUS
Suffix:
Gender:F
Credentials:BSPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2460 STONECROSS CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-7939
Mailing Address - Country:US
Mailing Address - Phone:407-207-8779
Mailing Address - Fax:
Practice Address - Street 1:2251 N SEMORAN BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-2915
Practice Address - Country:US
Practice Address - Phone:407-702-1154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS36069183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist