Provider Demographics
NPI:1508642497
Name:KLJUCEVIC, GLORIA (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:GLORIA
Middle Name:
Last Name:KLJUCEVIC
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1928 SHEFFIELD CT
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-2620
Mailing Address - Country:US
Mailing Address - Phone:727-518-5657
Mailing Address - Fax:
Practice Address - Street 1:1921 N BELCHER RD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33763-4548
Practice Address - Country:US
Practice Address - Phone:727-712-3450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS66272183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist