Provider Demographics
NPI:1982426706
Name:THEODORE, ANNE-RACHELE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ANNE-RACHELE
Middle Name:
Last Name:THEODORE
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 1:1351 NW 159TH LN
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1631
Mailing Address - Country:US
Mailing Address - Phone:754-244-8661
Mailing Address - Fax:
Practice Address - Street 1:1351 NW 159TH LN
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-1631
Practice Address - Country:US
Practice Address - Phone:754-244-8661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33541183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist