Provider Demographics
NPI:1154925436
Name:GAYLE, ALICIA (PHARM D)
Entity type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:
Last Name:GAYLE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9202 NUGENT TRL
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-6325
Mailing Address - Country:US
Mailing Address - Phone:561-236-3110
Mailing Address - Fax:
Practice Address - Street 1:11000 N MILITARY TRL
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-6597
Practice Address - Country:US
Practice Address - Phone:561-626-7542
Practice Address - Fax:561-627-6485
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-26
Last Update Date:2020-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS47787183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS47787OtherRPH LICENSE