Provider Demographics
NPI:1659775781
Name:PARCHEJO, LORALEI ANN MAGADIA (LPN, RPHT)
Entity Type:Individual
Prefix:
First Name:LORALEI ANN
Middle Name:MAGADIA
Last Name:PARCHEJO
Suffix:
Gender:F
Credentials:LPN, RPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10016 PINES BLVD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6137
Mailing Address - Country:US
Mailing Address - Phone:954-435-7200
Mailing Address - Fax:954-438-1030
Practice Address - Street 1:173 NE 108TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI SHORES
Practice Address - State:FL
Practice Address - Zip Code:33161
Practice Address - Country:US
Practice Address - Phone:305-758-1178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-17
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRPT57569OtherFLORIDA BOARD OF PHARMACY