Provider Demographics
NPI:1629351002
Name:LANDER, CARMEN FELICIA (PS)
Entity Type:Individual
Prefix:MRS
First Name:CARMEN
Middle Name:FELICIA
Last Name:LANDER
Suffix:
Gender:F
Credentials:PS
Other - Prefix:MRS
Other - First Name:CARMEN
Other - Middle Name:FELICIA
Other - Last Name:LANDER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PS
Mailing Address - Street 1:13989 LANDSTAR BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32824-5501
Mailing Address - Country:US
Mailing Address - Phone:407-888-9868
Mailing Address - Fax:407-888-9895
Practice Address - Street 1:13989 LANDSTAR BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32824-5501
Practice Address - Country:US
Practice Address - Phone:407-888-9868
Practice Address - Fax:407-888-9895
Is Sole Proprietor?:No
Enumeration Date:2011-09-22
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0416461835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS 41646OtherPHARMACIST LICENSE