MEDICARE: PAMELA PESSEL

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	1835P2201X	Ambulatory Care Pharmacist	37035	FL

General Provider Information

NPI Number	:	1417887696
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA PESSEL

Provider Business Mailing Address
First Line	:	313 AVENTURINE AVE
Second Line	:
City	:	ST AUGUSTINE
State	:	FL
Zip	:	32086-0371
Country	:	US
Telephone Number	:	904-742-0815
Fax Number	:

Provider Business Practice Location Address
First Line	:	313 AVENTURINE AVE
Second Line	:
City	:	SAINT AUGUSTINE
State	:	FL
Zip	:	32086-0371
Country	:	US
Telephone Number	:	904-742-0815
Fax Number	:

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

Provider Enumeration Date	:	05/20/2026
Last Update Date	:	05/20/2026

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Directions to “ PAMELA PESSEL ” Practice Location

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