Provider Demographics
NPI:1447598909
Name:REDDICK, SONJA YVETTE (RPH)
Entity Type:Individual
Prefix:MS
First Name:SONJA
Middle Name:YVETTE
Last Name:REDDICK
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 OCALA RD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32304-1669
Mailing Address - Country:US
Mailing Address - Phone:850-575-6997
Mailing Address - Fax:850-575-8050
Practice Address - Street 1:800 OCALA RD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32304-1669
Practice Address - Country:US
Practice Address - Phone:850-575-6997
Practice Address - Fax:850-575-8050
Is Sole Proprietor?:No
Enumeration Date:2013-01-17
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS25997183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist