Provider Demographics
NPI:1568208015
Name:ECKER, KENNETH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:
Last Name:ECKER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:KEN
Other - Middle Name:
Other - Last Name:ECKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:134 SHORES POINTE DR
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-3318
Mailing Address - Country:US
Mailing Address - Phone:561-951-5956
Mailing Address - Fax:
Practice Address - Street 1:134 SHORES POINTE DR
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-3318
Practice Address - Country:US
Practice Address - Phone:561-951-5956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0030425183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist