Provider Demographics
NPI:1700215423
Name:SYNE, QAYSARA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:QAYSARA
Middle Name:
Last Name:SYNE
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 1:7171 CYPRESS LAKE DR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-6521
Mailing Address - Country:US
Mailing Address - Phone:239-415-3802
Mailing Address - Fax:
Practice Address - Street 1:7171 CYPRESS LAKE DR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-6521
Practice Address - Country:US
Practice Address - Phone:239-415-3802
Practice Address - Fax:239-415-3817
Is Sole Proprietor?:No
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS51312183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1356451967OtherCOSTCO WHOLESALE