Provider Demographics
NPI:1871197178
Name:CONCEICAO, BRIANA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BRIANA
Middle Name:
Last Name:CONCEICAO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:BRIANA
Other - Middle Name:
Other - Last Name:CASHMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:795 W GRANADA BLVD
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-9510
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:795 W GRANADA BLVD
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-9510
Practice Address - Country:US
Practice Address - Phone:386-672-7227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-26
Last Update Date:2020-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS54576183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist