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General NPI Number Information
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NPI Number | 1821488719
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Entity Type | Individual
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Provider Name | BETTY EMERY R.PH
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Gender | Female
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Dates
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Enumeration Date | 01/29/2015
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Last Update Date | 01/29/2015
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Provider Practice Location Address
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Address Line | 450 E BURLEIGH BLVD
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City | TAVARES
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State | FL
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Zip | 32778-5257
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Country | US
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Telephone | 352-343-6436
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Fax |
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Provider Business Mailing Address
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Address Line | 35544 ESTES RD
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City | EUSTIS
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State | FL
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Zip | 32736-7705
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Country | US
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Telephone |
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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 | PS22334
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License Number State | FL
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