Provider Demographics
NPI:1174166789
Name:HUDSON, NEIL R (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NEIL
Middle Name:R
Last Name:HUDSON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 BRAELOCK DR
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-4618
Mailing Address - Country:US
Mailing Address - Phone:407-271-0324
Mailing Address - Fax:
Practice Address - Street 1:8990 TURKEY LAKE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7320
Practice Address - Country:US
Practice Address - Phone:407-351-2191
Practice Address - Fax:407-351-2710
Is Sole Proprietor?:No
Enumeration Date:2019-10-26
Last Update Date:2019-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS49943183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist