Healthcare Provider Details

I. General information

NPI: 1316777535
Provider Name (Legal Business Name): MARY ROSE ALFUENTE OCAMPO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2024
Last Update Date: 08/02/2024
Certification Date: 08/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 SW ARCHER RD
GAINESVILLE FL
32608-1135
US

IV. Provider business mailing address

9150 SW 72ND CT
GAINESVILLE FL
32608-0239
US

V. Phone/Fax

Practice location:
  • Phone: 352-548-6000
  • Fax:
Mailing address:
  • Phone: 210-850-6042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1161770
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: