Provider Demographics
NPI:1144567876
Name:PALSIS, DANIELLE CHRISTIN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:CHRISTIN
Last Name:PALSIS
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 1:644 FRANKLYN AVE
Mailing Address - Street 2:
Mailing Address - City:INDIALANTIC
Mailing Address - State:FL
Mailing Address - Zip Code:32903-4604
Mailing Address - Country:US
Mailing Address - Phone:321-698-3356
Mailing Address - Fax:
Practice Address - Street 1:644 FRANKLYN AVE
Practice Address - Street 2:
Practice Address - City:INDIALANTIC
Practice Address - State:FL
Practice Address - Zip Code:32903-4604
Practice Address - Country:US
Practice Address - Phone:321-698-3356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-15
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCPH35877183500000X
FLPS49050183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist