Individual
ALYSSA W SANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.PH.
Contact information
Practice address
405 S LAWRENCE BLVD, KEYSTONE HEIGHTS, FL 32656-9222
(352) 478-2057
(352) 478-2059
Mailing address
658 NE 171ST ST, STARKE, FL 32091-5723
(904) 966-0078
(352) 478-2059
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS32098
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PS32098
STATE PHARMACIST LICENCE
FL
Enumeration date
05/21/2007
Last updated
02/08/2008
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