Most Relevant Information
Provider Data
| NPI Number: | 1003567728 |
| Provider Name: | KY DESMARATTES PHARMD |
| Entity Type: | Individual |
| Taxonomy Code: | 3336C0003X |
| Specialty: | Pharmacy |
| License Number: | PS62004 |
Most Important Dates
| Enumeration Date: | 01/13/2022 |
| Last Updated: | 01/13/2022 |
Provider Practice Location
2767 W US HIGHWAY 90
LAKE CITY
FL
320554755
Practice Location Phone/Fax
| Phone: | 3867552427 |
| Fax: |
Provider Mailing Location
169 BELLA VISTA WAY
ROYAL PALM BEACH
FL
334114309
Provider Mailing Phone/Fax
| Phone: | 5617141298 |
| Fax: |