Provider Demographics
NPI:1487496808
Name:MUNN, EMALEIGH MARIE (RPH)
Entity type:Individual
Prefix:DR
First Name:EMALEIGH
Middle Name:MARIE
Last Name:MUNN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:698 NW 126TH TER
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32669-0225
Mailing Address - Country:US
Mailing Address - Phone:662-507-8058
Mailing Address - Fax:
Practice Address - Street 1:14040 W NEWBERRY RD
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:FL
Practice Address - Zip Code:32669-2763
Practice Address - Country:US
Practice Address - Phone:352-332-6255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS67044183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist