Provider Demographics
NPI:1710271564
Name:RINTELMAN LAWHORN, JODI LYN (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:JODI
Middle Name:LYN
Last Name:RINTELMAN LAWHORN
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 1:100 TECHNOLOGY PARK STE 158
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-6205
Mailing Address - Country:US
Mailing Address - Phone:866-842-2147
Mailing Address - Fax:
Practice Address - Street 1:112 WEDGE CIR
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32124-2068
Practice Address - Country:US
Practice Address - Phone:608-358-8393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV23571183500000X
FLPS48296183500000X
WI15222-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist