Provider Demographics
NPI:1972184695
Name:NERETTE JR, EDOUARD (PHARMD)
Entity Type:Individual
Prefix:
First Name:EDOUARD
Middle Name:
Last Name:NERETTE JR
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2320 SW 67TH LN
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-2757
Mailing Address - Country:US
Mailing Address - Phone:754-802-4423
Mailing Address - Fax:
Practice Address - Street 1:2500 W BROWARD BLVD
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-1300
Practice Address - Country:US
Practice Address - Phone:954-453-6537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS57777183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist