Provider Demographics
NPI:1508143744
Name:CHORATH, TESSY C (RPH)
Entity Type:Individual
Prefix:MRS
First Name:TESSY
Middle Name:C
Last Name:CHORATH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5999 PEMBROKE RD
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33023-2341
Mailing Address - Country:US
Mailing Address - Phone:954-964-7274
Mailing Address - Fax:954-964-1822
Practice Address - Street 1:5999 PEMBROKE RD
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33023-2341
Practice Address - Country:US
Practice Address - Phone:954-964-7274
Practice Address - Fax:954-964-1822
Is Sole Proprietor?:No
Enumeration Date:2011-11-15
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0022872183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist