Provider Demographics
NPI:1689210247
Name:GRABOSKY, JANE
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:GRABOSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 TURTLE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-4282
Mailing Address - Country:US
Mailing Address - Phone:954-341-4706
Mailing Address - Fax:954-341-5776
Practice Address - Street 1:3801 TURTLE CREEK DR
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-4282
Practice Address - Country:US
Practice Address - Phone:954-341-4706
Practice Address - Fax:954-341-5776
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-19
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS26803183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist