Provider Demographics
NPI:1467055756
Name:MAGUIRE, CRYSTAL B (PHARMD, CPH)
Entity Type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:B
Last Name:MAGUIRE
Suffix:
Gender:F
Credentials:PHARMD, CPH
Other - Prefix:DR
Other - First Name:CRYSTAL
Other - Middle Name:R
Other - Last Name:BURCHFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:4237 SALISBURY RD STE 301
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-0908
Mailing Address - Country:US
Mailing Address - Phone:904-683-4298
Mailing Address - Fax:904-683-4922
Practice Address - Street 1:4237 SALISBURY RD STE 301
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-0908
Practice Address - Country:US
Practice Address - Phone:904-683-4298
Practice Address - Fax:904-683-4922
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS47890183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist