Provider Demographics
NPI:1659985000
Name:ESHIETEDOHO, VICTORIA A (PHARMACIST)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:A
Last Name:ESHIETEDOHO
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1488 AUTUMN PINES DR
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32065-2716
Mailing Address - Country:US
Mailing Address - Phone:954-665-7136
Mailing Address - Fax:
Practice Address - Street 1:2094 W US HIGHWAY 90
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32055-4720
Practice Address - Country:US
Practice Address - Phone:386-755-0313
Practice Address - Fax:386-755-5994
Is Sole Proprietor?:No
Enumeration Date:2020-09-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS54432183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist