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General NPI Number Information
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NPI Number | 1912501826
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Entity Type | Individual
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Provider Name | IRENE LOPES SUNDERMAN RPH
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Gender | Female
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Dates
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Enumeration Date | 11/23/2020
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Last Update Date | 11/23/2020
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Provider Practice Location Address
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Address Line | 13998 WALSINGHAM RD
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City | LARGO
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State | FL
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Zip | 33774-3224
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Country | US
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Telephone | 727-595-2521
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Fax | 727-596-8046
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Provider Business Mailing Address
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Address Line | 13998 WALSINGHAM RD
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City | LARGO
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State | FL
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Zip | 33774
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Country | US
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Telephone | 727-595-2521
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Fax | 727-596-8046
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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 | 30872
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License Number State | FL
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