Provider Demographics
NPI:1609144203
Name:QUIJADA, WENDY JACKELYN (PHARMD)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:JACKELYN
Last Name:QUIJADA
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 1:15005 SW 88TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-1314
Mailing Address - Country:US
Mailing Address - Phone:305-383-1409
Mailing Address - Fax:305-383-1409
Practice Address - Street 1:15005 SW 88TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-1314
Practice Address - Country:US
Practice Address - Phone:305-383-1409
Practice Address - Fax:305-383-1409
Is Sole Proprietor?:No
Enumeration Date:2011-12-09
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS48515183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist