Provider Demographics
NPI:1245942507
Name:ARENCIBIA, GREGORY STEVEN (PHARMD, CRPH)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:STEVEN
Last Name:ARENCIBIA
Suffix:
Gender:M
Credentials:PHARMD, CRPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13800 66TH ST
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-4909
Mailing Address - Country:US
Mailing Address - Phone:727-499-7228
Mailing Address - Fax:
Practice Address - Street 1:13800 66TH ST
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-4909
Practice Address - Country:US
Practice Address - Phone:727-499-7228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPU9091183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist