Provider Demographics
NPI:1982981551
Name:KRESS, GEORGE THOMAS (RPH)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:THOMAS
Last Name:KRESS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2540 NE 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:WILTON MANORS
Mailing Address - State:FL
Mailing Address - Zip Code:33305-1310
Mailing Address - Country:US
Mailing Address - Phone:954-390-0445
Mailing Address - Fax:954-561-5437
Practice Address - Street 1:2540 NE 15TH AVE
Practice Address - Street 2:
Practice Address - City:WILTON MANORS
Practice Address - State:FL
Practice Address - Zip Code:33305-1310
Practice Address - Country:US
Practice Address - Phone:954-390-0445
Practice Address - Fax:954-561-5437
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-10
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS36018183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist