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General NPI Number Information
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NPI Number | 1710627005
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Entity Type | Individual
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Provider Name | MARIANN SUSAN HUBER RPH
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Gender | Female
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Dates
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Enumeration Date | 04/01/2022
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Last Update Date | 04/01/2022
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Provider Practice Location Address
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Address Line | 2710 DEL PRADO BLVD S
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City | CAPE CORAL
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State | FL
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Zip | 33904-5788
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Country | US
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Telephone | 239-574-1932
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Fax |
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Provider Business Mailing Address
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Address Line | 1310 SE 14TH TER
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City | CAPE CORAL
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State | FL
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Zip | 33990-3700
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Country | US
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Telephone | 440-536-1204
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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 | 03221519
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS41807
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License Number State | FL
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