Provider Demographics
NPI:1952683690
Name:DROZD, THERESA MARIE (RPH)
Entity Type:Individual
Prefix:MS
First Name:THERESA
Middle Name:MARIE
Last Name:DROZD
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 N FLAGLER DR
Mailing Address - Street 2:UNIT 110
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-6530
Mailing Address - Country:US
Mailing Address - Phone:561-512-2658
Mailing Address - Fax:
Practice Address - Street 1:1805 N FLAGLER DR
Practice Address - Street 2:UNIT 110
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-6530
Practice Address - Country:US
Practice Address - Phone:561-512-2658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-19
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30795183500000X
CT6698183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist