Individual
BERNARD MBALLESUBE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D
Contact information
Practice address
5151 BELLE TERRE PKWY, PALM COAST, FL 32137-8689
(386) 446-9449
(386) 446-9971
Mailing address
5151 BELLE TERRE PKWY, PALM COAST, FL 32137-8689
(386) 446-9449
(386) 446-9971
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PS40873
FL
Other
Enumeration date
01/13/2021
Last updated
01/13/2021
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