Healthcare Provider Details

I. General information

NPI: 1588660187
Provider Name (Legal Business Name): RICHARD DAVID CAGLE RPH, DPH, PD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/28/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 SW 17TH ST
OCALA FL
34474-5138
US

IV. Provider business mailing address

5075 NE 7TH PL
OCALA FL
34470-1193
US

V. Phone/Fax

Practice location:
  • Phone: 352-622-4148
  • Fax: 352-622-0130
Mailing address:
  • Phone: 352-236-1750
  • Fax: 352-622-0130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS0023037
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: