Healthcare Provider Details

I. General information

NPI: 1396731022
Provider Name (Legal Business Name): DENISE A BARTER RPH MBA
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

708 SATINLEAF AVE
OLDSMAR FL
34677-4516
US

IV. Provider business mailing address

708 SATINLEAF AVE
OLDSMAR FL
34677-4516
US

V. Phone/Fax

Practice location:
  • Phone: 813-855-9089
  • Fax: 813-855-9089
Mailing address:
  • Phone: 813-855-9089
  • Fax: 813-855-9089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS19705
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPU2543
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: