Provider Demographics
NPI:1740559426
Name:KILEVSKAYA, ELINA (PHARMD)
Entity Type:Individual
Prefix:
First Name:ELINA
Middle Name:
Last Name:KILEVSKAYA
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 1:3909 SE 15TH PL APT 2B
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-7180
Mailing Address - Country:US
Mailing Address - Phone:954-593-1256
Mailing Address - Fax:
Practice Address - Street 1:905 CAPE CORAL PKWY E
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-9015
Practice Address - Country:US
Practice Address - Phone:239-945-1076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-23
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS48224183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist