Provider Demographics
NPI:1588771968
Name:GRESS, RODNEY LEE (RPH)
Entity type:Individual
Prefix:MR
First Name:RODNEY
Middle Name:LEE
Last Name:GRESS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5161 SW 17TH CT
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-5405
Mailing Address - Country:US
Mailing Address - Phone:954-792-8864
Mailing Address - Fax:
Practice Address - Street 1:901 N NOB HILL RD
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-1077
Practice Address - Country:US
Practice Address - Phone:954-452-1126
Practice Address - Fax:954-452-1618
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0013047183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist