Provider Demographics
NPI:1659618478
Name:JOZWIAK, DEBRA A (RPH)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:A
Last Name:JOZWIAK
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 S HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-2374
Mailing Address - Country:US
Mailing Address - Phone:727-443-7411
Mailing Address - Fax:727-442-3882
Practice Address - Street 1:1555 S HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-2374
Practice Address - Country:US
Practice Address - Phone:727-443-7411
Practice Address - Fax:727-442-3882
Is Sole Proprietor?:No
Enumeration Date:2013-01-14
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS34080183500000X
NY037357-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist