Provider Demographics
NPI:1548989197
Name:LAVOSKY, RICHARD III (PHARMD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:LAVOSKY
Suffix:III
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 NW 24TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-4434
Mailing Address - Country:US
Mailing Address - Phone:904-679-2805
Mailing Address - Fax:
Practice Address - Street 1:3700 NW 126TH AVE
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-2408
Practice Address - Country:US
Practice Address - Phone:888-224-5181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS64719183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist