Healthcare Provider Details

I. General information

NPI: 1245143544
Provider Name (Legal Business Name): NANCY FARAGALLA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2026
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7420 STATE ROAD 54
NEW PORT RICHEY FL
34653-6110
US

IV. Provider business mailing address

7420 STATE ROAD 54
NEW PORT RICHEY FL
34653-6110
US

V. Phone/Fax

Practice location:
  • Phone: 727-376-5064
  • Fax: 727-376-3981
Mailing address:
  • Phone: 727-376-5064
  • Fax: 727-376-3981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS71255
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: