Provider Demographics
NPI:1245434943
Name:BARBEE JR, JERRY A (PHARM D)
Entity type:Individual
Prefix:DR
First Name:JERRY
Middle Name:A
Last Name:BARBEE JR
Suffix:
Gender:M
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 1:3544 SWEET BAY DR
Mailing Address - Street 2:
Mailing Address - City:PACE
Mailing Address - State:FL
Mailing Address - Zip Code:32571-8936
Mailing Address - Country:US
Mailing Address - Phone:850-494-4001
Mailing Address - Fax:
Practice Address - Street 1:3544 SWEET BAY DR
Practice Address - Street 2:
Practice Address - City:PACE
Practice Address - State:FL
Practice Address - Zip Code:32571-8936
Practice Address - Country:US
Practice Address - Phone:850-494-4001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL17408183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist