Provider Demographics
NPI:1881285385
Name:WRIGHT, LYNELLE (RPH)
Entity type:Individual
Prefix:
First Name:LYNELLE
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6810 SE 67TH CT
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:FL
Mailing Address - Zip Code:32693-2908
Mailing Address - Country:US
Mailing Address - Phone:352-215-4050
Mailing Address - Fax:
Practice Address - Street 1:6810 SE 67TH CT
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:FL
Practice Address - Zip Code:32693-2908
Practice Address - Country:US
Practice Address - Phone:352-215-4050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS30067183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist