Provider Demographics
NPI:1497092449
Name:KOUNS, CRYSTAL MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:MARIE
Last Name:KOUNS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:CRISSIE
Other - Middle Name:MARIE
Other - Last Name:KOUNS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2040 58TH AVE
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32966-4646
Mailing Address - Country:US
Mailing Address - Phone:772-563-2065
Mailing Address - Fax:772-563-2072
Practice Address - Street 1:2040 58TH AVE
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32966-4646
Practice Address - Country:US
Practice Address - Phone:772-563-2065
Practice Address - Fax:772-563-2072
Is Sole Proprietor?:No
Enumeration Date:2013-01-10
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS47798183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist