Provider Demographics
NPI:1649270281
Name:BENNETT, TAMMY L (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:L
Last Name:BENNETT
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 1:2815 SW 98TH DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-8679
Mailing Address - Country:US
Mailing Address - Phone:352-331-6275
Mailing Address - Fax:352-375-3830
Practice Address - Street 1:5801 SW 75TH ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-8513
Practice Address - Country:US
Practice Address - Phone:352-375-1605
Practice Address - Fax:352-375-3830
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS35686183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist