Provider Demographics
NPI:1427058429
Name:FELDMAN, GERALD L (RPH)
Entity type:Individual
Prefix:
First Name:GERALD
Middle Name:L
Last Name:FELDMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8065 W OAKLAND PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-1118
Mailing Address - Country:US
Mailing Address - Phone:954-741-5650
Mailing Address - Fax:954-741-8689
Practice Address - Street 1:8065 W OAKLAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-1118
Practice Address - Country:US
Practice Address - Phone:954-741-5650
Practice Address - Fax:954-741-8689
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 9121183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist