Individual
FERNANDO LARA HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1305 S GREENFIELD RD, MESA, AZ 85206-3303
(480) 830-9266
Mailing address
12605 W PARADISE DR, EL MIRAGE, AZ 85335-7326
(623) 418-4782
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S023721
AZ
Other
Enumeration date
03/26/2019
Last updated
03/26/2019
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