=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760765101
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DR. ALMANDA ANTOINETTE HUME
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/22/2011
-----------------------------------------------------
Last Update Date | 12/22/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1954 SW GATLIN BLVD
-----------------------------------------------------
City | PORT ST LUCIE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34953-2722
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 772-224-3020
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1954 SW GATLIN BLVD
-----------------------------------------------------
City | PORT ST LUCIE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34953-2722
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 772-224-3020
-----------------------------------------------------
Fax | 772-878-9388
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | PS40286
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------