Provider Demographics
NPI:1043206725
Name:KHOURY, ADONICE PAUL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ADONICE
Middle Name:PAUL
Last Name:KHOURY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11511 NW 13TH LN
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-0426
Mailing Address - Country:US
Mailing Address - Phone:321-693-1858
Mailing Address - Fax:
Practice Address - Street 1:780 SE BAYA DR
Practice Address - Street 2:BAYA PHARMACY EAST
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025-5403
Practice Address - Country:US
Practice Address - Phone:386-755-6677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 387801835G0303X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1835G0303XPharmacy Service ProvidersPharmacistGeriatric
Not Answered183500000XPharmacy Service ProvidersPharmacist