Provider Demographics
NPI:1609295252
Name:VERDERBER, KRISTEN KOHL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:KOHL
Last Name:VERDERBER
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 1:660 NE LAKEVIEW TER
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-6914
Mailing Address - Country:US
Mailing Address - Phone:561-317-4440
Mailing Address - Fax:
Practice Address - Street 1:660 NE LAKEVIEW TER
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6914
Practice Address - Country:US
Practice Address - Phone:561-317-4440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-10
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS41432183500000X
GARPH023294183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist