Provider Demographics
NPI:1811695067
Name:NORONHA, ALLWYN (PHARMD)
Entity type:Individual
Prefix:
First Name:ALLWYN
Middle Name:
Last Name:NORONHA
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 1:5360 CASA REAL DR
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6667
Mailing Address - Country:US
Mailing Address - Phone:561-573-1068
Mailing Address - Fax:
Practice Address - Street 1:5730 CORPORATE WAY STE 130
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2032
Practice Address - Country:US
Practice Address - Phone:561-815-1945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS65357183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist