Provider Demographics
NPI:1588723944
Name:ROSE, RENEE LEIGH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:RENEE
Middle Name:LEIGH
Last Name:ROSE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:RENEE
Other - Middle Name:LEIGH
Other - Last Name:BELZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:4364 CALEDONIA AVE
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-6051
Mailing Address - Country:US
Mailing Address - Phone:407-889-4332
Mailing Address - Fax:407-814-6185
Practice Address - Street 1:2725 S BINION RD
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-8504
Practice Address - Country:US
Practice Address - Phone:407-884-2034
Practice Address - Fax:407-814-6185
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS38472183500000X
IA18797183500000X
MA24283183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist