Provider Demographics
NPI:1679238125
Name:OBANDO, CHRISTIAN PHILLIP (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:PHILLIP
Last Name:OBANDO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14758 SILVER GLEN DR E
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-5159
Mailing Address - Country:US
Mailing Address - Phone:904-386-5459
Mailing Address - Fax:
Practice Address - Street 1:14758 SILVER GLEN DR E
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-5159
Practice Address - Country:US
Practice Address - Phone:904-386-5459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS63281183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist