Provider Demographics
NPI:1508454141
Name:BRADY, CELIA A (RPH)
Entity Type:Individual
Prefix:
First Name:CELIA
Middle Name:A
Last Name:BRADY
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 1:6810 STIRLING RD
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-1842
Mailing Address - Country:US
Mailing Address - Phone:954-661-8621
Mailing Address - Fax:954-989-0065
Practice Address - Street 1:6810 STIRLING RD
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-1842
Practice Address - Country:US
Practice Address - Phone:954-989-0085
Practice Address - Fax:954-989-0065
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS31457183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist