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NPI Code Detail

MEDICARE: MRS. NANCY COLELLA OQUENDO RPH

MEDICARE:  MRS. NANCY COLELLA OQUENDO  RPH
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
1183500000XPharmacistPS36172FL

General Provider Information

NPI Number : 1790117570
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. NANCY COLELLA OQUENDO RPH
Provider Business Mailing Address
First Line : 8603 WEST HILLSBOROUGH AVE
Second Line :
City : TAMPA
State : FL
Zip : 33615
Country : US
Telephone Number : 813-882-4029
Fax Number : 813-885-4865
Provider Business Practice Location Address
First Line : 8603 W HILLSBOROUGH AVE
Second Line :
City : TAMPA
State : FL
Zip : 33615-3810
Country : US
Telephone Number : 813-882-4029
Fax Number : 813-885-4862
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2013
Last Update Date : 08/05/2013

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Directions to “ MRS. NANCY COLELLA OQUENDO RPH” Practice Location

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