Provider Demographics
NPI:1013522853
Name:RHOADS, ELLAMY LYNNE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ELLAMY
Middle Name:LYNNE
Last Name:RHOADS
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 1:14921 NORTHWOOD VILLAGE LN
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-1521
Mailing Address - Country:US
Mailing Address - Phone:813-417-8160
Mailing Address - Fax:
Practice Address - Street 1:16011 N NEBRASKA AVE STE 103
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33549-6158
Practice Address - Country:US
Practice Address - Phone:813-999-2700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-09
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS59237183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist