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NPI Code Detail

MEDICARE: COURTNEY ELISE ROBERTS PHARMD

MEDICARE: COURTNEY ELISE ROBERTS PHARMD
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
1183500000XPharmacistPS50859FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PS50859OTHERFLFLORIDA BOARD OF PHARMACY

General Provider Information

NPI Number : 1942636329
Entity Type Code : Individual
Provider Name (Legal Business Name) : COURTNEY ELISE ROBERTS PHARMD
Provider Business Mailing Address
First Line : 1313 S DALE MABRY HWY
Second Line :
City : TAMPA
State : FL
Zip : 33629-5010
Country : US
Telephone Number : 813-258-9301
Fax Number :
Provider Business Practice Location Address
First Line : 1313 S DALE MABRY HWY
Second Line :
City : TAMPA
State : FL
Zip : 33629-5010
Country : US
Telephone Number : 813-258-9301
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2013
Last Update Date : 09/18/2013

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Directions to “ COURTNEY ELISE ROBERTS PHARMD” Practice Location

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