Provider Demographics
NPI:1851964027
Name:BISHOP, MANDY CRYSTAL (PHARMD)
Entity Type:Individual
Prefix:
First Name:MANDY
Middle Name:CRYSTAL
Last Name:BISHOP
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 1:976 SUMMERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34120-1415
Mailing Address - Country:US
Mailing Address - Phone:239-682-0351
Mailing Address - Fax:
Practice Address - Street 1:15265 COLLIER BLVD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-7715
Practice Address - Country:US
Practice Address - Phone:239-349-9759
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-23
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS62721183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist