Provider Demographics
NPI:1952810939
Name:WEATHERBY, DANA LEIGH (PHARMD)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:LEIGH
Last Name:WEATHERBY
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 1:582 MONROE RD STE 1412B
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-8821
Mailing Address - Country:US
Mailing Address - Phone:407-357-2618
Mailing Address - Fax:407-805-8545
Practice Address - Street 1:582 MONROE RD STE 1412B
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-8821
Practice Address - Country:US
Practice Address - Phone:407-357-2618
Practice Address - Fax:407-805-8545
Is Sole Proprietor?:No
Enumeration Date:2017-09-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS49151183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist