Provider Demographics
NPI:1548559560
Name:ANCHETA, GEORGE (RPH)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:
Last Name:ANCHETA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20505 S DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-1229
Mailing Address - Country:US
Mailing Address - Phone:130-525-4252
Mailing Address - Fax:130-525-4207
Practice Address - Street 1:20505 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-1229
Practice Address - Country:US
Practice Address - Phone:130-525-4252
Practice Address - Fax:130-525-4207
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-30
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19033183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist