Provider Demographics
NPI:1255418521
Name:CHATMAN, ALICIA RUVIENE (PHARMD,CDE,BCADM)
Entity type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:RUVIENE
Last Name:CHATMAN
Suffix:
Gender:F
Credentials:PHARMD,CDE,BCADM
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:RUVIENE
Other - Last Name:HARDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD, CDE BC-ADM
Mailing Address - Street 1:10496 HENBURY ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-6956
Mailing Address - Country:US
Mailing Address - Phone:407-289-9447
Mailing Address - Fax:
Practice Address - Street 1:10496 HENBURY ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-6956
Practice Address - Country:US
Practice Address - Phone:407-289-9447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS416361835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist