Provider Demographics
NPI:1750660593
Name:REYNOLDS, WENDY MARIAH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:MARIAH
Last Name:REYNOLDS
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 1:155 CORRINE PL
Mailing Address - Street 2:
Mailing Address - City:KEY LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33037-4205
Mailing Address - Country:US
Mailing Address - Phone:404-580-4756
Mailing Address - Fax:
Practice Address - Street 1:155 CORRINE PL
Practice Address - Street 2:
Practice Address - City:KEY LARGO
Practice Address - State:FL
Practice Address - Zip Code:33037-4205
Practice Address - Country:US
Practice Address - Phone:404-580-4756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-10
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS47821183500000X
GARPH026098183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist