Individual
DR. BENJAMIN J VILLAVICENCIO-LAZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
3505 UNIVERSITY BLVD W, JACKSONVILLE, FL 32217-2130
(904) 636-0778
Mailing address
3505 UNIVERSITY BLVD W, JACKSONVILLE, FL 32217-2130
(904) 636-0778
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS48356
FL
Other
Enumeration date
12/16/2011
Last updated
12/16/2011
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