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General NPI Number Information
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NPI Number | 1497368559
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Entity Type | Individual
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Provider Name | SAMUEL GAISIE ASANTE PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/28/2020
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Last Update Date | 08/28/2020
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Provider Practice Location Address
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Address Line | 3035 APALACHEE PKWY
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City | TALLAHASSEE
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State | FL
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Zip | 32301-5104
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Country | US
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Telephone | 850-402-4046
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Fax |
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Provider Business Mailing Address
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Address Line | 5800 BEACH BLVD # 203-180
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City | JACKSONVILLE
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State | FL
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Zip | 32207-5120
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Country | US
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Telephone | 904-207-0410
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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 | PS58789
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License Number State | FL
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