Healthcare Provider Details

I. General information

NPI: 1033049051
Provider Name (Legal Business Name): SAMUEL JOSEPH BORGERT PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

679 TURKEY CRK
ALACHUA FL
32615-9310
US

IV. Provider business mailing address

679 TURKEY CRK
ALACHUA FL
32615-9310
US

V. Phone/Fax

Practice location:
  • Phone: 352-222-1938
  • Fax:
Mailing address:
  • Phone: 352-222-1938
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835I0206X
TaxonomyInfectious Diseases Pharmacist
License NumberPS22776
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: