Provider Demographics
NPI:1578859633
Name:WALDROP, JILL MARGARET (PHARMD, MD)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:MARGARET
Last Name:WALDROP
Suffix:
Gender:F
Credentials:PHARMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 N SOCRUM LOOP RD
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33809-4181
Mailing Address - Country:US
Mailing Address - Phone:863-859-3611
Mailing Address - Fax:863-859-6170
Practice Address - Street 1:6600 N. SOCRUM LOOP
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33809
Practice Address - Country:US
Practice Address - Phone:863-859-3611
Practice Address - Fax:863-859-6170
Is Sole Proprietor?:No
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25377183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist