Healthcare Provider Details

I. General information

NPI: 1861739617
Provider Name (Legal Business Name): PAULA HURD PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PAULA STASEK PHARMD

II. Dates (important events)

Enumeration Date: 01/14/2013
Last Update Date: 01/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 N COURTENAY PKWY
MERRITT ISLAND FL
32953
US

IV. Provider business mailing address

1850 N COURTENAY PKWY
MERRITT ISLAND FL
32953-2629
US

V. Phone/Fax

Practice location:
  • Phone: 321-986-6393
  • Fax: 321-986-6293
Mailing address:
  • Phone: 321-986-6393
  • Fax: 321-986-6268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS33679
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: