Provider Demographics
NPI:1366053134
Name:CHOI, EEJONG (PHARMD)
Entity type:Individual
Prefix:
First Name:EEJONG
Middle Name:
Last Name:CHOI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7415 N HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32927-5008
Mailing Address - Country:US
Mailing Address - Phone:321-213-6233
Mailing Address - Fax:321-638-4183
Practice Address - Street 1:7415 N HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32927-5008
Practice Address - Country:US
Practice Address - Phone:321-213-6233
Practice Address - Fax:321-638-4183
Is Sole Proprietor?:No
Enumeration Date:2020-08-13
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS54020183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist