Provider Demographics
NPI:1902230543
Name:GOTTSTEIN, KAYLA M (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KAYLA
Middle Name:M
Last Name:GOTTSTEIN
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 1:1534 CAPE CORAL PKWY W
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33914-6953
Mailing Address - Country:US
Mailing Address - Phone:239-541-2035
Mailing Address - Fax:
Practice Address - Street 1:1534 CAPE CORAL PKWY W
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33914-6953
Practice Address - Country:US
Practice Address - Phone:239-541-2035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-30
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS51061183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist