Individual
DR. LATOY RENAE WAITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
2480 TAMIAMI TRL, PORT CHARLOTTE, FL 33952-3922
(941) 625-0023
Mailing address
17697 NW 19TH AVE, MIAMI GARDENS, FL 33056-4816
(786) 985-8600
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PS60016
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NONE
—
FL
Enumeration date
01/27/2020
Last updated
01/27/2020
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