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NPI Code Detail

MEDICARE: MRS. KATHRYN ELIZABETH CORLIETO

MEDICARE: MRS. KATHRYN ELIZABETH CORLIETO
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
1183500000XPharmacistPS20423FL

General Provider Information

NPI Number : 1447597216
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATHRYN ELIZABETH CORLIETO
Provider Business Mailing Address
First Line : 11851 PALM BEACH BLVD
Second Line :
City : FORT MYERS
State : FL
Zip : 33905-5912
Country : US
Telephone Number : 239-690-9570
Fax Number :
Provider Business Practice Location Address
First Line : 11851 PALM BEACH BLVD
Second Line :
City : FORT MYERS
State : FL
Zip : 33905-5912
Country : US
Telephone Number : 239-690-9570
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2013
Last Update Date : 01/13/2013

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Directions to “ MRS. KATHRYN ELIZABETH CORLIETO ” Practice Location

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