Provider Demographics
NPI:1215532163
Name:KESTEN, AIMEE B
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:B
Last Name:KESTEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12077 S ORANGE BLOSSOM TRL
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-9581
Mailing Address - Country:US
Mailing Address - Phone:407-240-2474
Mailing Address - Fax:407-859-0326
Practice Address - Street 1:12077 S ORANGE BLOSSOM TRL
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-9581
Practice Address - Country:US
Practice Address - Phone:407-240-2474
Practice Address - Fax:407-859-0326
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS35486183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist