Provider Demographics
NPI:1891525713
Name:LASPINA, TALIA MARIE (RPH)
Entity type:Individual
Prefix:
First Name:TALIA
Middle Name:MARIE
Last Name:LASPINA
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 1:13700 RICHMOND PARK DR N APT 504
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-4274
Mailing Address - Country:US
Mailing Address - Phone:321-652-9350
Mailing Address - Fax:
Practice Address - Street 1:2680 RACE TRACK RD
Practice Address - Street 2:
Practice Address - City:ST JOHNS
Practice Address - State:FL
Practice Address - Zip Code:32259-6278
Practice Address - Country:US
Practice Address - Phone:904-230-6718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS67380183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist