Provider Demographics
NPI:1730543513
Name:CLAUD, CANDACE NICOLE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CANDACE
Middle Name:NICOLE
Last Name:CLAUD
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 1:535 HORSEMAN DR
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-6787
Mailing Address - Country:US
Mailing Address - Phone:407-340-0636
Mailing Address - Fax:
Practice Address - Street 1:535 HORSEMAN DR
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-6787
Practice Address - Country:US
Practice Address - Phone:407-340-0636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-07
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 49620183500000X
IL051297410183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist