Provider Demographics
NPI:1760853832
Name:MINOZZI, CHERYL ADELE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:ADELE
Last Name:MINOZZI
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 1:5524 SCOTT VIEW LN
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-3064
Mailing Address - Country:US
Mailing Address - Phone:863-669-3939
Mailing Address - Fax:
Practice Address - Street 1:5524 SCOTT VIEW LN
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-3064
Practice Address - Country:US
Practice Address - Phone:863-669-3939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-14
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS42154183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist