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General NPI Number Information
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NPI Number | 1396015798
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Entity Type | Individual
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Provider Name | FRUSNEL AUGUSTIN RPH
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Gender | Male
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Dates
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Enumeration Date | 01/03/2012
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Last Update Date | 07/27/2020
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Provider Practice Location Address
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Address Line | 8246 SILVER BIRCH WAY
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City | LEHIGH ACRES
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State | FL
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Zip | 33971-3718
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Country | US
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Telephone | 239-240-0824
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Fax | 239-658-1310
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Provider Business Mailing Address
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Address Line | 2611 30TH ST SW
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City | LEHIGH ACRES
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State | FL
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Zip | 33976-4091
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Country | US
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Telephone | 239-240-4345
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Fax | 239-931-3605
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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 | PS37279
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License Number State | FL
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