Individual
JANELLE REBERNIGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
202 E BRANDON BLVD, BRANDON, FL 33511-5221
(813) 689-3521
Mailing address
202 E BRANDON BLVD, BRANDON, FL 33511-5221
(813) 689-3521
Taxonomy
Speciality
Code
Description
License number
State
1835G0303X
Geriatric Pharmacist
PS50163
FL
1835P1200X
Pharmacotherapy Pharmacist
Primary
PS50163
FL
3336C0003X
Community/Retail Pharmacy
PS50163
FL
3336C0004X
Compounding Pharmacy
PS50163
FL
Other
Enumeration date
05/21/2020
Last updated
05/21/2020
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