Healthcare Provider Details

I. General information

NPI: 1356333652
Provider Name (Legal Business Name): ANITA K. TRUITT PHARMD.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2005
Last Update Date: 08/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 BAY PINES BLVD.
BAY PINES FL
33744
US

IV. Provider business mailing address

7390 HUNT CLUB LN
SEMINOLE FL
33776-4227
US

V. Phone/Fax

Practice location:
  • Phone: 727-398-6661
  • Fax: 727-319-1271
Mailing address:
  • Phone: 727-398-6661
  • Fax: 727-319-1271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number14842
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: