Provider Demographics
NPI:1417295759
Name:BRBOVIC, VEDRANA
Entity type:Individual
Prefix:
First Name:VEDRANA
Middle Name:
Last Name:BRBOVIC
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 1:13898 GREENTREE TRL
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-4021
Mailing Address - Country:US
Mailing Address - Phone:561-533-6885
Mailing Address - Fax:561-585-0185
Practice Address - Street 1:13898 GREENTREE TRL
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414
Practice Address - Country:US
Practice Address - Phone:561-533-6885
Practice Address - Fax:561-585-0185
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS41541183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist