Individual
DAVID HASEBROOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
2223 BLUE HIGHLANDS DR, LAKELAND, FL 33811-2840
(813) 203-4783
Mailing address
2223 BLUE HIGHLANDS DR, LAKELAND, FL 33811-2840
(813) 203-4783
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
23133
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23133
FLORIDA DEPART OF HEALTH
FL
Enumeration date
02/10/2022
Last updated
02/10/2022
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