Provider Demographics
NPI:1649843517
Name:BRIDGES, PRINCESS (RPH)
Entity type:Individual
Prefix:
First Name:PRINCESS
Middle Name:
Last Name:BRIDGES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1522 PALM BEACH LAKES BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-2302
Mailing Address - Country:US
Mailing Address - Phone:561-344-8454
Mailing Address - Fax:
Practice Address - Street 1:3053 SW MARTIN DOWNS BLVD
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-2644
Practice Address - Country:US
Practice Address - Phone:772-288-0105
Practice Address - Fax:772-288-5063
Is Sole Proprietor?:No
Enumeration Date:2021-07-20
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS62694183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist