Provider Demographics
NPI:1306115563
Name:LIQUORI, NANCY MARIA
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:MARIA
Last Name:LIQUORI
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 1:1480 FALCONWOOD CT
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-2347
Mailing Address - Country:US
Mailing Address - Phone:407-814-7929
Mailing Address - Fax:
Practice Address - Street 1:1201 W SR 436
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-2736
Practice Address - Country:US
Practice Address - Phone:407-389-7353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-17
Last Update Date:2011-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS029902183500000X
NYPH042989183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist