Healthcare Provider Details

I. General information

NPI: 1801193719
Provider Name (Legal Business Name): MICHELLE LYNN VITOLA PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE LYNN RASH

II. Dates (important events)

Enumeration Date: 02/12/2011
Last Update Date: 09/30/2022
Certification Date: 09/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1298 E NORVELL BRYANT HWY STE D
HERNANDO FL
34442-4992
US

IV. Provider business mailing address

1298 E NORVELL BRYANT HWY STE D
HERNANDO FL
34442-4992
US

V. Phone/Fax

Practice location:
  • Phone: 352-419-8949
  • Fax: 855-829-8663
Mailing address:
  • Phone: 352-419-8949
  • Fax: 352-344-4727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS32732
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: