Provider Demographics
NPI:1619571155
Name:ZADROZNY, BEBI ANISSA
Entity Type:Individual
Prefix:
First Name:BEBI
Middle Name:ANISSA
Last Name:ZADROZNY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 E HIGHWAY 50
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-1914
Mailing Address - Country:US
Mailing Address - Phone:352-243-7030
Mailing Address - Fax:352-243-7961
Practice Address - Street 1:1800 E HIGHWAY 50
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-1914
Practice Address - Country:US
Practice Address - Phone:352-243-7030
Practice Address - Fax:357-243-7961
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS28873183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty