Provider Demographics
NPI:1396027173
Name:GIMBRONE, JOE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOE
Middle Name:
Last Name:GIMBRONE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 MARION OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34473-2513
Mailing Address - Country:US
Mailing Address - Phone:352-307-1304
Mailing Address - Fax:
Practice Address - Street 1:260 MARION OAKS BLVD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34473-2513
Practice Address - Country:US
Practice Address - Phone:352-307-1304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS41731183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist