Provider Demographics
NPI:1679186233
Name:CHAYAUD, LOODANE (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:LOODANE
Middle Name:
Last Name:CHAYAUD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15180 TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:NORTH PORT
Mailing Address - State:FL
Mailing Address - Zip Code:34287-2742
Mailing Address - Country:US
Mailing Address - Phone:941-423-6100
Mailing Address - Fax:941-423-6700
Practice Address - Street 1:15180 TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34287-2742
Practice Address - Country:US
Practice Address - Phone:941-423-6100
Practice Address - Fax:941-423-6700
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS60402183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist