Provider Demographics
NPI:1386245389
Name:LEFROCK, JEFFREY (PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:
Last Name:LEFROCK
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10314 BELLWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34654-5900
Mailing Address - Country:US
Mailing Address - Phone:727-916-1040
Mailing Address - Fax:
Practice Address - Street 1:27727 STATE ROAD 56
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-8833
Practice Address - Country:US
Practice Address - Phone:813-929-7095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS23707183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist