MEDICARE: DR. KURT WAYNE NIX PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PS37518	FL
2	183500000X	Pharmacist	PD09521	AR
3	183500000X	Pharmacist	013243	KY

General Provider Information

NPI Number	:	1285620997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KURT WAYNE NIX PHARM.D.

Provider Business Mailing Address
First Line	:	9848 E BAY ST
Second Line	:
City	:	SEMINOLE
State	:	FL
Zip	:	33776-1617
Country	:	US
Telephone Number	:	727-398-6661
Fax Number	:

Provider Business Practice Location Address
First Line	:	10000 BAY PINES BLVD
Second Line	:
City	:	BAY PINES
State	:	FL
Zip	:	33744-8200
Country	:	US
Telephone Number	:	727-398-6661
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2005
Last Update Date	:	02/26/2013

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