Provider Demographics
NPI:1669813143
Name:LENT, CHRISTOPHER GEORGE (BPHARM)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:GEORGE
Last Name:LENT
Suffix:
Gender:M
Credentials:BPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3980 MONTEREY ST
Mailing Address - Street 2:
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32927-8458
Mailing Address - Country:US
Mailing Address - Phone:321-639-3513
Mailing Address - Fax:
Practice Address - Street 1:695 N WASHINGTON AVE STE 101
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32796-2101
Practice Address - Country:US
Practice Address - Phone:321-747-0600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-11
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS21226183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist