Provider Demographics
NPI:1770062838
Name:BROXTON, CAROL METCHELL (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:METCHELL
Last Name:BROXTON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:
Other - Last Name:MONTGOMERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2200 S MONROE ST
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-6303
Mailing Address - Country:US
Mailing Address - Phone:800-939-2002
Mailing Address - Fax:
Practice Address - Street 1:2200 S MONROE ST
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-6303
Practice Address - Country:US
Practice Address - Phone:800-939-2002
Practice Address - Fax:855-523-0910
Is Sole Proprietor?:No
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH467031835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist