Provider Demographics
NPI:1760939755
Name:SURLES, FRANCES (PHAMD)
Entity Type:Individual
Prefix:DR
First Name:FRANCES
Middle Name:
Last Name:SURLES
Suffix:
Gender:F
Credentials:PHAMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3020 RABON RD
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:FL
Mailing Address - Zip Code:32344-7803
Mailing Address - Country:US
Mailing Address - Phone:850-545-6086
Mailing Address - Fax:
Practice Address - Street 1:1247 S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:FL
Practice Address - Zip Code:32344-7803
Practice Address - Country:US
Practice Address - Phone:850-545-6086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS55527183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist