Provider Demographics
NPI:1659358299
Name:BROWN-SLATER, ANDREA MARIE (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:MARIE
Last Name:BROWN-SLATER
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 1:872 W ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32310-6123
Mailing Address - Country:US
Mailing Address - Phone:850-606-8250
Mailing Address - Fax:850-412-7834
Practice Address - Street 1:872 W ORANGE AVE
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32310-6123
Practice Address - Country:US
Practice Address - Phone:850-606-8250
Practice Address - Fax:850-412-7834
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-26
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS40241183500000X
FLPU6571183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist