Provider Demographics
NPI:1447847017
Name:KEROLOS, CHRISTEN (PHARMACIST)
Entity type:Individual
Prefix:
First Name:CHRISTEN
Middle Name:
Last Name:KEROLOS
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33915 US 19 N
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-2628
Mailing Address - Country:US
Mailing Address - Phone:727-784-6200
Mailing Address - Fax:727-784-6210
Practice Address - Street 1:33915 US 19 N
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-2628
Practice Address - Country:US
Practice Address - Phone:727-784-6200
Practice Address - Fax:727-784-6210
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS48892183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist