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General NPI Number Information
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NPI Number | 1881540722
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Entity Type | Individual
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Provider Name | DAVID MICHAEL VIDAL PHARMD
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Gender | Male
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Dates
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Enumeration Date | 03/04/2026
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Last Update Date | 03/04/2026
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Provider Practice Location Address
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Address Line | 1700 S 23RD ST
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City | FORT PIERCE
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State | FL
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Zip | 34950-4803
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Country | US
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Telephone | 772-461-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 3202 SW BUENA VISTA DR
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City | PALM CITY
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State | FL
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Zip | 34990-5492
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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 | 1835C0205X
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Taxonomy Name | Critical Care Pharmacist
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License Number | PS43883
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License Number State | FL
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