Healthcare Provider Details

I. General information

NPI: 1154204493
Provider Name (Legal Business Name): GERRIT MEJIA-NACCARATO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2025
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5324 LITTLE RD
NEW PORT RICHEY FL
34655-1294
US

IV. Provider business mailing address

6603 CATALPA DR
NEW PORT RICHEY FL
34655-3701
US

V. Phone/Fax

Practice location:
  • Phone: 727-375-5377
  • Fax:
Mailing address:
  • Phone: 727-301-8730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number69157
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: