Provider Demographics
NPI:1528276987
Name:SABELLA, NELINA HEARNE (RPH)
Entity type:Individual
Prefix:MRS
First Name:NELINA
Middle Name:HEARNE
Last Name:SABELLA
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 1:10537 CASTLEBAR GLEN DR S
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-9115
Mailing Address - Country:US
Mailing Address - Phone:904-525-0456
Mailing Address - Fax:
Practice Address - Street 1:5207 NORMANDY BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32205-4827
Practice Address - Country:US
Practice Address - Phone:904-642-9550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0030539183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS0030539OtherSTATE LICENSE NUMBER