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General NPI Number Information
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NPI Number | 1821474883
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Entity Type | Individual
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Provider Name | BENJAMIN OTERO-SALVATELLA JR. PHARM D
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Gender | Male
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Dates
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Enumeration Date | 07/31/2015
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Last Update Date | 07/31/2015
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Provider Practice Location Address
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Address Line | 1010 N MILITARY TRL
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City | HAVERHILL
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State | FL
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Zip | 33409-6011
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Country | US
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Telephone | 561-471-1655
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Fax |
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Provider Business Mailing Address
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Address Line | 134 VAN GOGH WAY
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City | ROYAL PALM BEACH
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State | FL
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Zip | 33411-1580
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Country | US
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Telephone | 561-236-6046
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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 | PS53761
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License Number State | FL
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