Provider Demographics
NPI:1679158539
Name:MENKIN, CHRISTINE E (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:E
Last Name:MENKIN
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 1:1885 TEMPLE DR
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-1662
Mailing Address - Country:US
Mailing Address - Phone:407-647-8064
Mailing Address - Fax:
Practice Address - Street 1:1885 TEMPLE DR
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-1662
Practice Address - Country:US
Practice Address - Phone:407-647-8064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-12
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS17528183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist