Provider Demographics
NPI:1124305123
Name:WESTON, BEVERLY G (RPH)
Entity type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:G
Last Name:WESTON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 N. UNIVERSITY DRIVE
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2015
Mailing Address - Country:US
Mailing Address - Phone:954-472-3861
Mailing Address - Fax:954-472-4159
Practice Address - Street 1:181 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2015
Practice Address - Country:US
Practice Address - Phone:954-472-3861
Practice Address - Fax:954-472-4159
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 13388183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist