Provider Demographics
NPI:1952886350
Name:REDA, LAUREN C (PHARMD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:C
Last Name:REDA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:C
Other - Last Name:JAMES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5535 1ST AVE E APT 204
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-6092
Mailing Address - Country:US
Mailing Address - Phone:321-693-1747
Mailing Address - Fax:
Practice Address - Street 1:11205 STATE ROAD 70 E
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34202-9404
Practice Address - Country:US
Practice Address - Phone:941-727-4962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-01
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS58506183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist