Provider Demographics
NPI:1992150106
Name:TEEL, ERIC (PHARM D)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:TEEL
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9360 NAVARRE PKWY
Mailing Address - Street 2:
Mailing Address - City:NAVARRE
Mailing Address - State:FL
Mailing Address - Zip Code:32566-2910
Mailing Address - Country:US
Mailing Address - Phone:850-939-3717
Mailing Address - Fax:
Practice Address - Street 1:9360 NAVARRE PKWY
Practice Address - Street 2:
Practice Address - City:NAVARRE
Practice Address - State:FL
Practice Address - Zip Code:32566-2910
Practice Address - Country:US
Practice Address - Phone:850-939-3717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-26
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS54184183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist