Provider Demographics
NPI:1619622883
Name:KRISE, AIMEE ARIEL (PHARMD)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:ARIEL
Last Name:KRISE
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 1:2548 NW 99TH AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-6207
Mailing Address - Country:US
Mailing Address - Phone:954-775-6742
Mailing Address - Fax:
Practice Address - Street 1:2548 NW 99TH AVE
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-6207
Practice Address - Country:US
Practice Address - Phone:954-775-6742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS54450183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist