Provider Demographics
NPI:1013511187
Name:LUNDY, PIERRE JUSTIN VIKEMSON (PHARMD)
Entity Type:Individual
Prefix:
First Name:PIERRE JUSTIN
Middle Name:VIKEMSON
Last Name:LUNDY
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 1:6096 W W KELLEY RD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32311-7720
Mailing Address - Country:US
Mailing Address - Phone:954-773-3515
Mailing Address - Fax:
Practice Address - Street 1:1708 N MONROE ST
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-5535
Practice Address - Country:US
Practice Address - Phone:850-385-6136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-29
Last Update Date:2020-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS56795183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist