Provider Demographics
NPI:1053900795
Name:METELLUS, FELICIA (PHARMD)
Entity type:Individual
Prefix:
First Name:FELICIA
Middle Name:
Last Name:METELLUS
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 1:311 OAK LANE TRAK
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34472-9339
Mailing Address - Country:US
Mailing Address - Phone:352-653-7677
Mailing Address - Fax:
Practice Address - Street 1:2449 E SILVER SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-6908
Practice Address - Country:US
Practice Address - Phone:352-401-9492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-17
Last Update Date:2021-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS59306183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist