Provider Demographics
NPI:1831468545
Name:CLEVELAND, LAURIE CAREY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:CAREY
Last Name:CLEVELAND
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 1:5336 ROWE TRL
Mailing Address - Street 2:
Mailing Address - City:PACE
Mailing Address - State:FL
Mailing Address - Zip Code:32571-9547
Mailing Address - Country:US
Mailing Address - Phone:850-994-3291
Mailing Address - Fax:
Practice Address - Street 1:700 N PACE BLVD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32505-7500
Practice Address - Country:US
Practice Address - Phone:850-432-7144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-26
Last Update Date:2011-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS29600183500000X
AL13019183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist