Individual
MR. EDNER DORLOUIS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
619 S MARION AVE, LAKE CITY, FL 32025-5808
(386) 755-3016
Mailing address
8204 SW 61ST PL, GAINESVILLE, FL 32608-5589
(352) 281-5351
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
RPT17531
FL
Other
Enumeration date
04/01/2011
Last updated
04/01/2011
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