Provider Demographics
NPI:1487909222
Name:CHO, IRENE (PHARMD)
Entity type:Individual
Prefix:MS
First Name:IRENE
Middle Name:
Last Name:CHO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3729 GRANDEWOOD BLVD
Mailing Address - Street 2:APT. 811
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-7365
Mailing Address - Country:US
Mailing Address - Phone:352-262-0497
Mailing Address - Fax:
Practice Address - Street 1:120 W GRANT ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-3932
Practice Address - Country:US
Practice Address - Phone:407-608-1580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS49124183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist