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General NPI Number Information
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NPI Number | 1255982203
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Entity Type | Individual
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Provider Name | PATTI CHARLES PHARMD
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Gender | Female
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Dates
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Enumeration Date | 09/21/2019
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Last Update Date | 02/21/2020
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Provider Practice Location Address
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Address Line | 10741 US HIGHWAY 1
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City | SEBASTIAN
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State | FL
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Zip | 32958-8441
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Country | US
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Telephone | 772-473-5007
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Fax |
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Provider Business Mailing Address
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Address Line | 10741 US HIGHWAY 1
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City | SEBASTIAN
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State | FL
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Zip | 32958-8441
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Country | US
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Telephone | 772-783-6457
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Fax | 772-783-6460
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | PS40250
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License Number State | FL
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