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NPI Code Detail

MEDICARE: ALEX LAMAR WALDRON

MEDICARE: ALEX LAMAR WALDRON
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
1183500000XPharmacistPS66744FL

General Provider Information

NPI Number : 1821859497
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEX LAMAR WALDRON
Provider Business Mailing Address
First Line : 4738 W GANDY BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33611-3308
Country : US
Telephone Number : 813-837-1848
Fax Number : 813-837-1965
Provider Business Practice Location Address
First Line : 4738 W GANDY BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33611-3308
Country : US
Telephone Number : 813-837-1848
Fax Number : 813-837-1965
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2024
Last Update Date : 01/19/2024

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Directions to “ ALEX LAMAR WALDRON ” Practice Location

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