Provider Demographics
NPI:1205251741
Name:RODRIGUEZ, LILLYBELL (PHARM D)
Entity type:Individual
Prefix:
First Name:LILLYBELL
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3839 PLEASANT HILL RD
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34746-2952
Mailing Address - Country:US
Mailing Address - Phone:407-343-7878
Mailing Address - Fax:
Practice Address - Street 1:3839 PLEASANT HILL RD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34746-2952
Practice Address - Country:US
Practice Address - Phone:407-343-7878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-20
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS42038183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist