1609312164 NPI number — UNIVERSITY OF FLORIDA COLLEGE OF PHARMACY MEDICATION MANAGEMENT

Table of content: ZENAIDO MARTINEZ III BA (NPI 1508922535)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609312164 NPI number — UNIVERSITY OF FLORIDA COLLEGE OF PHARMACY MEDICATION MANAGEMENT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY OF FLORIDA COLLEGE OF PHARMACY MEDICATION MANAGEMENT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609312164
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/09/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2046 NE WALDO RD STE 3100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GAINESVILLE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32609-8977
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
352-273-9694
Provider Business Mailing Address Fax Number:
352-273-9658

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2046 NE WALDO RD STE 3100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GAINESVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32609-8977
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-273-9694
Provider Business Practice Location Address Fax Number:
352-273-9658
Provider Enumeration Date:
01/09/2017

Additional Information

Authorized Official

Authorized Official Last Name:
SALO
Authorized Official First Name:
JENNIFER
Authorized Official Middle Name:
Authorized Official Title or Position:
ASSISTANT DIRECTOR OF OPERATIONS AN
Authorized Official Telephone Number:
352-273-9694

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  PS53612 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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