MALENA BULLARD (NPI# 1003102914) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003102914 |
| Entity Type | Individual |
| Full Name | MALENA BULLARD |
| Credential | PHARM D |
| Practice Address |
1205 S Woodland Blvd Ste 5 Deland FL 32720 |
| Mailing Address |
2650 Dakota Dr Deland FL 32724-9636 |
| Practice Telephone | 3868884912 |
| Practice Fax Number | 3862699950 |
| Mailing Telephone | 3106345362 |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2018-08-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | RPH50132 | CA | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | PS32524 | FL | Pharmacy Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2575 Enterprise Rd, Target Pharmacy Store Number T0874, Orange City, FL 327637960 | 3867746477 | 3867746477 |
| Street Address |
1205 S WOODLAND BLVD STE 5 |
| City | DELAND |
| State | FL |
| Zip Code | 32720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619512217 | Charles B Greenhouse | Pharmacist | 1205 S Woodland Blvd Ste 5, Deland, FL 32720-7464 | 2019-11-07 |
| 1447720743 | Northeast Florida Health Services Inc | Clinic/Center | 1205 S Woodland Blvd Ste 5, Deland, FL 32720-7464 | 2018-11-29 |
| 1063903672 | Northeast Florida Health Services Inc | Pharmacy | 1205 S Woodland Blvd Ste 5, Deland, FL 32720-7464 | 2018-05-21 |
| 1750802567 | Marlo Waddle | Pharmacist | 1205 S Woodland Blvd Ste 5, Deland, FL 32720-7464 | 2017-06-30 |
| 1467907626 | Northeast Florida Health Services, Inc. | Clinic/Center | 1205 S Woodland Blvd Ste 5, Deland, FL 32720-7464 | 2016-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679171532 | Kimberlee C Del Campo | Nurse Practitioner | 1590 S, State Highway 15a, Deland, FL 32720 | 2020-10-13 |
| 1699304840 | Grace Haven LLC | In Home Supportive Care | 805 S Stone St, Deland, FL 32720 | 2020-04-08 |
| 1609407766 | Michelle Rene' Tutt | Nurse Practitioner | 1590 South State Hwy 15a, Deland, FL 32720 | 2020-01-28 |
| 1902448715 | Volusia Medical Center LLC | Family Medicine | 850 N. Stone Street, Deland, FL 32720 | 2019-10-14 |
| 1548748957 | Christopher Lee Paik | Internal Medicine | 107 N Stone St, St A, Deland, FL 32720 | 2018-07-30 |
| 1164961041 | Melissa Sorensen | Counselor | 970 N Spring Ave, 523, Deland, FL 32720 | 2017-02-13 |
| 1669910329 | Stefanie Briann Yockey | Counselor | 804 N. Woodland Blvd., Deland, FL 32720 | 2017-02-02 |
| 1144648809 | Steven Shinn | Internal Medicine | 1590 S Sr 15a Ste 100, Deland, FL 32720 | 2014-03-31 |
| 1164843710 | Malgorzata Anna Szelwach | Occupational Therapist | 1590 State Rt 15a Suite B, Deland, FL 32720 | 2013-12-29 |
| 1730510926 | Adriana Marquez | Community/Behavioral Health | 33218 Tomahawk Trail, Deland, FL 32720 | 2013-12-12 |
| Find all providers in zip 32720 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003284613 | Kimberly Marie Clifton | Pharmacist | 1701 Old Daytona Rd, Deland, FL 32724-8511 | 2015-09-14 |
| 1790127918 | Ivan L Bradley | Pharmacist | 519 Hemingway Ct, Deland, FL 32720-6782 | 2013-07-30 |
| 1477890051 | Thomas Main | Pharmacist | 299 E International Speedway Blvd, Deland, FL 32724-2339 | 2013-01-15 |
| 1578809356 | Donald J Reilly | Pharmacist | 1520 Rockingham Ln, Deland, FL 32724-7621 | 2012-12-22 |
| 1871862615 | Ruchita Mehul Patel | Pharmacist | 300 E New York Avenue, Deland, FL 32724-6752 | 2011-12-23 |
| 1902181183 | Frederick Hayward Kaiser | Pharmacist | 1590 S Woodland Blvd, Deland, FL 32720-7709 | 2011-10-19 |
| 1851411482 | David H Barnard | Pharmacist | 939 N Spring Garden Ave, Deland, FL 32720-2560 | 2007-03-29 |
| 1891839908 | June A. Hopp | Pharmacist | 2410 S Woodland Blvd, Deland, FL 32720-8636 | 2007-02-20 |
| 1508900614 | Peter J Seguinot IIi | Pharmacist | 2701 S Woodland Blvd, Winn Dixie Pharmacy #2341, Deland, FL 32720-7005 | 2007-02-20 |
| 1447865688 | Sara Wieser | Pharmacist | 300 E New York Ave, Deland, FL 32724-5532 | 2020-09-14 |
| Find all providers in DELAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.