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Individual

SEAN TYRONE USTIC

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
40100 HIGHWAY 27, DAVENPORT, FL 33837-5906
(863) 419-2366
Mailing address
616 POINTER LN, LAKELAND, FL 33809-4630
(520) 705-4255

Taxonomy

Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
PS45386
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PS45386
STATE OF FLORIDA PHARMACY LICENSE
FL
Enumeration date
12/05/2022
Last updated
12/05/2022
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