Provider Demographics
NPI:1871147587
Name:NARANJO, JUAN (PHARMD)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:
Last Name:NARANJO
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 1:10223 PALERMO CIR APT 103
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-5088
Mailing Address - Country:US
Mailing Address - Phone:305-610-1954
Mailing Address - Fax:
Practice Address - Street 1:10015 N DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-4409
Practice Address - Country:US
Practice Address - Phone:813-392-4207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-31
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS59552183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist