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General NPI Number Information
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NPI Number | 1194327619
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Entity Type | Individual
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Provider Name | CORNELIO NEAL GENILO PHARMD
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Gender | Male
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Dates
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Enumeration Date | 11/10/2020
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Last Update Date | 11/10/2020
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Provider Practice Location Address
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Address Line | AZ-86
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City | SELLS
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State | AZ
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Zip | 85634
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Country | US
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Telephone | 520-383-7350
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Fax | 520-383-7265
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Provider Business Mailing Address
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Address Line | 1925 W RIVER RD APT 4303
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City | TUCSON
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State | AZ
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Zip | 85704-1654
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Country | US
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Telephone | 727-481-5460
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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 | PS56047
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License Number State | FL
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