Provider Demographics
NPI:1982014692
Name:LIU, CHRISTOPHER (RPH)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:LIU
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1254 JACARANDA BLVD
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292
Mailing Address - Country:US
Mailing Address - Phone:941-497-3368
Mailing Address - Fax:941-492-6089
Practice Address - Street 1:1254 JACARANDA BLVD
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-4508
Practice Address - Country:US
Practice Address - Phone:941-497-3368
Practice Address - Fax:941-492-6089
Is Sole Proprietor?:No
Enumeration Date:2014-05-02
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS38333183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist