Provider Demographics
NPI:1659641231
Name:LE, DASHA BICH (PHARMD)
Entity type:Individual
Prefix:
First Name:DASHA
Middle Name:BICH
Last Name:LE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9629 BAY HARBOR CIR
Mailing Address - Street 2:APT. #201
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-5701
Mailing Address - Country:US
Mailing Address - Phone:727-641-2829
Mailing Address - Fax:
Practice Address - Street 1:9629 BAY HARBOR CIR.
Practice Address - Street 2:APT. 201
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919
Practice Address - Country:US
Practice Address - Phone:727-641-2829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-12
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS48277183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist