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General NPI Number Information
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NPI Number | 1588528046
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Entity Type | Individual
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Provider Name | MERCY J NINAN PHARM.D
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Gender | Female
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Dates
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Enumeration Date | 12/10/2025
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 3202 N PARK RD
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City | PLANT CITY
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State | FL
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Zip | 33563-2026
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Country | US
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Telephone | 813-757-1274
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Fax |
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Provider Business Mailing Address
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Address Line | 2819 MYSTIC OAKS DR
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City | PLANT CITY
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State | FL
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Zip | 33563-9004
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Country | US
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Telephone | 813-757-1274
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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 | 1835C0207X
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Taxonomy Name | Compounded Sterile Preparations Pharmacist
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License Number | PU5995
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License Number State | FL
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