Provider Demographics
NPI:1710319967
Name:FLEMING, JEFREY I (RPH)
Entity Type:Individual
Prefix:MR
First Name:JEFREY
Middle Name:I
Last Name:FLEMING
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2313 FORREST CREST CIR
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33549-3776
Mailing Address - Country:US
Mailing Address - Phone:813-434-3565
Mailing Address - Fax:
Practice Address - Street 1:2313 FORREST CREST CIR
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33549-3776
Practice Address - Country:US
Practice Address - Phone:813-434-3565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-30
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS20893183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist