Provider Demographics
NPI:1740483403
Name:TERRELL, CEDRIC ARTIMIS (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CEDRIC
Middle Name:ARTIMIS
Last Name:TERRELL
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 1:14454 CHERRY LAKE DR W
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-5138
Mailing Address - Country:US
Mailing Address - Phone:904-880-9375
Mailing Address - Fax:904-683-8770
Practice Address - Street 1:14454 CHERRY LAKE DR W
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-5138
Practice Address - Country:US
Practice Address - Phone:904-880-9375
Practice Address - Fax:904-683-8770
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS35127183500000X
FLPU61251835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835G0303XPharmacy Service ProvidersPharmacistGeriatric