Provider Demographics
NPI:1609234897
Name:ELLER, CAROLINE (PHARMD)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:ELLER
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 1:6525 NW 113TH WAY
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33076-3704
Mailing Address - Country:US
Mailing Address - Phone:954-348-2921
Mailing Address - Fax:
Practice Address - Street 1:6525 NW 113TH WAY
Practice Address - Street 2:
Practice Address - City:PARKLAND
Practice Address - State:FL
Practice Address - Zip Code:33076-3704
Practice Address - Country:US
Practice Address - Phone:954-348-2921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-03
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFPS45608183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist