Provider Demographics
NPI:1992040513
Name:VOSBURGH, KRISTIN LEE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:LEE
Last Name:VOSBURGH
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 1:2310 TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33950-5932
Mailing Address - Country:US
Mailing Address - Phone:941-575-6369
Mailing Address - Fax:941-575-8737
Practice Address - Street 1:2310 TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-5932
Practice Address - Country:US
Practice Address - Phone:941-575-6369
Practice Address - Fax:941-575-8737
Is Sole Proprietor?:No
Enumeration Date:2012-12-07
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS46430183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist