Provider Demographics
NPI:1205107661
Name:ZIPF, MANDY LYNN (PHARMD)
Entity type:Individual
Prefix:
First Name:MANDY
Middle Name:LYNN
Last Name:ZIPF
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 1:1712 INDIAN ROCKS RD
Mailing Address - Street 2:
Mailing Address - City:BELLEAIR
Mailing Address - State:FL
Mailing Address - Zip Code:33756-1656
Mailing Address - Country:US
Mailing Address - Phone:813-778-3025
Mailing Address - Fax:
Practice Address - Street 1:1712 INDIAN ROCKS RD
Practice Address - Street 2:
Practice Address - City:BELLEAIR
Practice Address - State:FL
Practice Address - Zip Code:33756-1656
Practice Address - Country:US
Practice Address - Phone:813-778-3025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-17
Last Update Date:2012-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS48123183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist