Provider Demographics
NPI:1992309157
Name:CAPERTON, MARJORIE BROOKE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MARJORIE
Middle Name:BROOKE
Last Name:CAPERTON
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 1:2641 ALEXANDER PL APT 301
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33763-1180
Mailing Address - Country:US
Mailing Address - Phone:513-550-0444
Mailing Address - Fax:
Practice Address - Street 1:10195 66TH ST N
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33782-3016
Practice Address - Country:US
Practice Address - Phone:727-541-4681
Practice Address - Fax:727-545-4301
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-27
Last Update Date:2020-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS57832183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist