Provider Demographics
NPI:1336419548
Name:MCMANUELS, JUDITH ELLEN (BPHARM)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:ELLEN
Last Name:MCMANUELS
Suffix:
Gender:F
Credentials:BPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 NE 23RD ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-4429
Mailing Address - Country:US
Mailing Address - Phone:352-732-8240
Mailing Address - Fax:
Practice Address - Street 1:3500 SE MARICAMP RD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-6248
Practice Address - Country:US
Practice Address - Phone:352-694-4193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-04
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS16634183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist