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General NPI Number Information
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NPI Number | 1114474079
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Entity Type | Individual
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Provider Name | SUBA K NATHAN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 09/07/2016
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Last Update Date | 05/06/2021
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Provider Practice Location Address
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Address Line | 6624 US HWY 19
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City | NEW PORT RICHEY
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State | FL
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Zip | 34652
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Country | US
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Telephone | 727-807-6050
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Fax |
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Provider Business Mailing Address
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Address Line | 11987 TREVALLY LOOP #204
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City | TRINITY
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State | FL
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Zip | 34655
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Country | US
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Telephone | 508-733-0769
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | P540910
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | R2753
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License Number State | NH
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