Healthcare Provider Details

I. General information

NPI: 1386646388
Provider Name (Legal Business Name): MICHAEL R. HALBERT PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: MICHAEL R. HALBERT PHARM.D.

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 02/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 18TH AVE S
ST PETERSBURG FL
33705-2734
US

IV. Provider business mailing address

109 18TH AVE S
ST PETERSBURG FL
33705-2734
US

V. Phone/Fax

Practice location:
  • Phone: 727-515-9261
  • Fax:
Mailing address:
  • Phone: 727-515-9261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberPS29204
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: