Provider Demographics
NPI:1952846271
Name:TOLBERT, AYONNA SIERRA (PHARMD)
Entity Type:Individual
Prefix:
First Name:AYONNA
Middle Name:SIERRA
Last Name:TOLBERT
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 1:4110 GEORGE RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:ROCKY POINT
Mailing Address - State:FL
Mailing Address - Zip Code:33634-7411
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4110 GEORGE RD
Practice Address - Street 2:SUITE 150
Practice Address - City:ROCKY POINT
Practice Address - State:FL
Practice Address - Zip Code:33634-7411
Practice Address - Country:US
Practice Address - Phone:813-892-9006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-22
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS55366183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist