Provider Demographics
NPI:1528425220
Name:CLEAVER, VIRGINIA DENISE (PHARMD, RPH, CPH)
Entity type:Individual
Prefix:DR
First Name:VIRGINIA
Middle Name:DENISE
Last Name:CLEAVER
Suffix:
Gender:F
Credentials:PHARMD, RPH, CPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6709 RIDGE RD STE 306
Mailing Address - Street 2:
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34668-6867
Mailing Address - Country:US
Mailing Address - Phone:727-203-3202
Mailing Address - Fax:855-898-8002
Practice Address - Street 1:6709 RIDGE RD STE 306
Practice Address - Street 2:
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-6867
Practice Address - Country:US
Practice Address - Phone:727-203-3202
Practice Address - Fax:855-898-8002
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-26
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302033259183500000X
FLPS33402183500000X, 1835P0018X
FLPU77501835P0018X, 1835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care