Provider Demographics
NPI:1558451617
Name:COON, JUDY ANDERSON (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JUDY
Middle Name:ANDERSON
Last Name:COON
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 1:2038 KIMBERWICKE CIR
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-7575
Mailing Address - Country:US
Mailing Address - Phone:407-366-0915
Mailing Address - Fax:
Practice Address - Street 1:2038 KIMBERWICKE CIR
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-7575
Practice Address - Country:US
Practice Address - Phone:407-366-0915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS23624183500000X
FLPU35361835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835G0303XPharmacy Service ProvidersPharmacistGeriatric