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General NPI Number Information
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NPI Number | 1396402202
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Entity Type | Individual
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Provider Name | DAISY IVANA VARGAS PHARMD
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Gender | Female
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Dates
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Enumeration Date | 11/27/2021
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Last Update Date | 11/27/2021
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Provider Practice Location Address
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Address Line | 4018 E SUNFLOWER CIR
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City | LABELLE
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State | FL
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Zip | 33935-5528
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Country | US
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Telephone | 305-316-3945
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Fax |
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Provider Business Mailing Address
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Address Line | 1525 COLONIAL BLVD
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City | FORT MYERS
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State | FL
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Zip | 33907-1021
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Country | US
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Telephone | 239-939-2191
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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 | PS63547
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License Number State | FL
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