Individual
LEIVAUGHN LYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9197 S FEDERAL HWY, PORT ST LUCIE, FL 34952-3405
(772) 335-4668
Mailing address
9197 S FEDERAL HWY, PORT ST LUCIE, FL 34952-3405
(772) 335-4668
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
61754
FL
Other
Enumeration date
11/20/2020
Last updated
11/20/2020
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