Provider Demographics
NPI:1386938215
Name:HIGUERA, DAVID LEONARDO (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LEONARDO
Last Name:HIGUERA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 W BUSH BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618
Mailing Address - Country:US
Mailing Address - Phone:813-931-8700
Mailing Address - Fax:
Practice Address - Street 1:2901 W BUSH BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618
Practice Address - Country:US
Practice Address - Phone:813-931-8700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL439021835N0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835N0905XPharmacy Service ProvidersPharmacistNuclear