Provider Demographics
NPI:1891073326
Name:HUGHES, KENNETH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:
Last Name:HUGHES
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:KENNETH
Other - Middle Name:
Other - Last Name:HUGHES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD, BCPS
Mailing Address - Street 1:5201 RAYMOND ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-8208
Mailing Address - Country:US
Mailing Address - Phone:321-397-6147
Mailing Address - Fax:321-397-6498
Practice Address - Street 1:5201 RAYMOND ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-8208
Practice Address - Country:US
Practice Address - Phone:321-397-6147
Practice Address - Fax:321-397-6498
Is Sole Proprietor?:No
Enumeration Date:2011-08-02
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 47868183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist