Basic Information
| Provider Information | |||||||||
| NPI: | 1326129032 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MARSH | ||||||||
| FirstName: | DARREN | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | PHARMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 110 S WOODLAND ST | ||||||||
| Address2: | |||||||||
| City: | WINTER GARDEN | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347873546 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4076160906 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | SOUTH LAKE FAMILY HEALTH CENTER | ||||||||
| Address2: | 1296 W BROAD STREET | ||||||||
| City: | GROVELAND | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347362012 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3524294104 | ||||||||
| FaxNumber: | 3524295606 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/18/2006 | ||||||||
| LastUpdateDate: | 02/10/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | PS34314 | FL | Y | Pharmacy Service Providers | Pharmacist |
ID Information
| ID | Type | State | Issuer | Description | PS34314 | 01 | FL | RPH LICENSE # | OTHER |