Provider Demographics
NPI:1639420938
Name:FLOYD, KEMBERLEY LA'TOYA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KEMBERLEY
Middle Name:LA'TOYA
Last Name:FLOYD
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 1:174 HANK DR
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:GA
Mailing Address - Zip Code:31763-5838
Mailing Address - Country:US
Mailing Address - Phone:706-414-1514
Mailing Address - Fax:
Practice Address - Street 1:174 HANK DR
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:GA
Practice Address - Zip Code:31763-5838
Practice Address - Country:US
Practice Address - Phone:706-414-1514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-26
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH023276183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist