Provider Demographics
NPI:1730124603
Name:TURNBLACER, MONICA (PHARMD, CPH)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:
Last Name:TURNBLACER
Suffix:
Gender:F
Credentials:PHARMD, CPH
Other - Prefix:MS
Other - First Name:MONICA
Other - Middle Name:
Other - Last Name:SIKORA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD, CPH
Mailing Address - Street 1:PO BOX 458
Mailing Address - Street 2:
Mailing Address - City:PORT SALERNO
Mailing Address - State:FL
Mailing Address - Zip Code:34992-0458
Mailing Address - Country:US
Mailing Address - Phone:561-346-3260
Mailing Address - Fax:772-220-1148
Practice Address - Street 1:4073 SE FAIRWAY E
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997-6172
Practice Address - Country:US
Practice Address - Phone:561-346-3260
Practice Address - Fax:772-220-1148
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS222581835N1003X, 1835P1200X, 1835P1300X
FLPU36471835N1003X, 1835P1200X, 1835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1835N1003XPharmacy Service ProvidersPharmacistNutrition Support
Not Answered1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Not Answered1835P1300XPharmacy Service ProvidersPharmacistPsychiatric