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General NPI Number Information
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NPI Number | 1225306004
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Entity Type | Individual
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Provider Name | VITALIA ALEXANDROV RPH
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Gender | Female
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Dates
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Enumeration Date | 12/07/2011
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Last Update Date | 12/07/2011
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Provider Practice Location Address
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Address Line | 300 E NEW YORK AVE
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City | DELAND
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State | FL
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Zip | 32724-5532
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Country | US
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Telephone | 386-943-4011
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Fax |
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Provider Business Mailing Address
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Address Line | 114 WOOD RIDGE TRL
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City | SANFORD
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State | FL
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Zip | 32771-8840
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Country | US
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Telephone | 407-497-9579
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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 | PS 33138
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License Number State | FL
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