Provider Demographics
NPI:1750673372
Name:HARRIS, RHENDA ALICEAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RHENDA
Middle Name:ALICEAN
Last Name:HARRIS
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 1:351 CHANNELSIDE WALK WAY
Mailing Address - Street 2:APT 4305
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-6765
Mailing Address - Country:US
Mailing Address - Phone:804-787-3045
Mailing Address - Fax:
Practice Address - Street 1:6735 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-8342
Practice Address - Country:US
Practice Address - Phone:727-384-9050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-16
Last Update Date:2011-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS47539183500000X
NC21579183500000X
VA0202208570183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist