Provider Demographics
NPI:1467823922
Name:HALL, ASHLEY RYDZEWSKI (PHARMD)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:RYDZEWSKI
Last Name:HALL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:N
Other - Last Name:RYDZEWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:250 E MIRACLE STRIP PKWY
Mailing Address - Street 2:
Mailing Address - City:MARY ESTHER
Mailing Address - State:FL
Mailing Address - Zip Code:32569-1924
Mailing Address - Country:US
Mailing Address - Phone:850-243-9557
Mailing Address - Fax:850-659-3287
Practice Address - Street 1:250 E MIRACLE STRIP PKWY
Practice Address - Street 2:
Practice Address - City:MARY ESTHER
Practice Address - State:FL
Practice Address - Zip Code:32569
Practice Address - Country:US
Practice Address - Phone:850-243-9557
Practice Address - Fax:850-659-3287
Is Sole Proprietor?:No
Enumeration Date:2015-10-09
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS53598183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist