Provider Demographics
NPI:1578176517
Name:PHILIPOSE, SUNILA SARAH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SUNILA
Middle Name:SARAH
Last Name:PHILIPOSE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10288 CYPRESS LAKES DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-3640
Mailing Address - Country:US
Mailing Address - Phone:904-363-0539
Mailing Address - Fax:
Practice Address - Street 1:11744 BEACH BLVD STE 107
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32246-8476
Practice Address - Country:US
Practice Address - Phone:904-380-0322
Practice Address - Fax:904-642-9269
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS37147183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist