Provider Demographics
NPI:1679726301
Name:ALCORN, JAMES SAMUEL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:SAMUEL
Last Name:ALCORN
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 1:325 CYPRESS PKWY
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34759-3326
Mailing Address - Country:US
Mailing Address - Phone:407-530-2035
Mailing Address - Fax:407-530-2031
Practice Address - Street 1:325 CYPRESS PKWY
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759-3326
Practice Address - Country:US
Practice Address - Phone:407-530-2035
Practice Address - Fax:407-530-2031
Is Sole Proprietor?:No
Enumeration Date:2008-10-26
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS56254183500000X
FL31582171835P1200X
FLPU86971835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL400101070541530OtherPTCB