Healthcare Provider Details

I. General information

NPI: 1629487467
Provider Name (Legal Business Name): ALBERT VINCENT CIFELLI PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2014
Last Update Date: 04/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2692 OAK RIDGE CT
FORT MYERS FL
33901-9351
US

IV. Provider business mailing address

2692 OAK RIDGE CT
FORT MYERS FL
33901-9351
US

V. Phone/Fax

Practice location:
  • Phone: 239-939-9226
  • Fax: 855-523-0910
Mailing address:
  • Phone: 239-939-9226
  • Fax: 855-523-0910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS51086
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: