Provider Demographics
NPI:1013532613
Name:RUFUS, KRYSTAL MARIE (PHARMD, MBA)
Entity Type:Individual
Prefix:DR
First Name:KRYSTAL
Middle Name:MARIE
Last Name:RUFUS
Suffix:
Gender:F
Credentials:PHARMD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 BALCOM TER SE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32909-6558
Mailing Address - Country:US
Mailing Address - Phone:321-720-5986
Mailing Address - Fax:
Practice Address - Street 1:901 E HACKBERRY AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-6502
Practice Address - Country:US
Practice Address - Phone:956-618-7100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX634251835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatricGroup - Single Specialty