Provider Demographics
NPI:1548503675
Name:ZALDIVAR, FERNANDO J (PHARM BS)
Entity type:Individual
Prefix:MR
First Name:FERNANDO
Middle Name:J
Last Name:ZALDIVAR
Suffix:
Gender:M
Credentials:PHARM BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2503 SW 181ST TER
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029-5196
Mailing Address - Country:US
Mailing Address - Phone:954-850-2227
Mailing Address - Fax:
Practice Address - Street 1:2503 SW 181ST TER
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33029-5196
Practice Address - Country:US
Practice Address - Phone:954-850-2227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-27
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS199521835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist