Provider Demographics
NPI:1477823078
Name:MORAN, HEATHER ANN (PHARM D)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:ANN
Last Name:MORAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4840 SUNDAY CT
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34235-2250
Mailing Address - Country:US
Mailing Address - Phone:941-799-0266
Mailing Address - Fax:
Practice Address - Street 1:5896 CORTEZ RD W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-2703
Practice Address - Country:US
Practice Address - Phone:941-792-3817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-12
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS43259183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist