Provider Demographics
NPI:1215274162
Name:WALKER, MARCELA GALLEGO (PHARMD)
Entity type:Individual
Prefix:
First Name:MARCELA
Middle Name:GALLEGO
Last Name:WALKER
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 1:601 WELDON BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-3866
Mailing Address - Country:US
Mailing Address - Phone:407-688-0575
Mailing Address - Fax:
Practice Address - Street 1:601 WELDON BLVD
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3866
Practice Address - Country:US
Practice Address - Phone:407-688-0575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-12
Last Update Date:2013-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS45004183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist