Individual
CARMEN WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11373 CORTEZ BLVD STE 101, BROOKSVILLE, FL 34613-5411
(352) 600-7838
Mailing address
11373 CORTEZ BLVD STE 101, BROOKSVILLE, FL 34613-5411
(352) 600-7838
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS38253
FL
Other
Enumeration date
04/19/2019
Last updated
06/11/2019
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