Provider Demographics
NPI:1811267388
Name:MURROW, GLADYS
Entity type:Individual
Prefix:MRS
First Name:GLADYS
Middle Name:
Last Name:MURROW
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:GLADYS
Other - Middle Name:
Other - Last Name:MURROW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:4232 NE OCEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:JENSEN BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34957-4307
Mailing Address - Country:US
Mailing Address - Phone:772-225-9800
Mailing Address - Fax:
Practice Address - Street 1:4232 NE OCEAN BLVD
Practice Address - Street 2:
Practice Address - City:JENSEN BEACH
Practice Address - State:FL
Practice Address - Zip Code:34957-4307
Practice Address - Country:US
Practice Address - Phone:772-225-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-30
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS39634183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist