Provider Demographics
NPI:1831436781
Name:KREIENBRINK, CLINTON D JR (PHARMD)
Entity type:Individual
Prefix:
First Name:CLINTON
Middle Name:D
Last Name:KREIENBRINK
Suffix:JR
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 1:3035 SE MARICAMP RD
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-6201
Mailing Address - Country:US
Mailing Address - Phone:352-351-2374
Mailing Address - Fax:352-351-2360
Practice Address - Street 1:3035 SE MARICAMP RD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-6201
Practice Address - Country:US
Practice Address - Phone:352-351-2374
Practice Address - Fax:352-351-2360
Is Sole Proprietor?:No
Enumeration Date:2013-01-12
Last Update Date:2013-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS36051183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist