Provider Demographics
NPI:1487646378
Name:HALFEN, MICHAEL W (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:W
Last Name:HALFEN
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 1:748 BOULDER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-9734
Mailing Address - Country:US
Mailing Address - Phone:850-475-7091
Mailing Address - Fax:850-475-7092
Practice Address - Street 1:4400 BAYOU BLVD
Practice Address - Street 2:SUITE 52
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2673
Practice Address - Country:US
Practice Address - Phone:850-475-7091
Practice Address - Fax:850-475-7092
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS32618183500000X
FLPU49361835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy