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NPI Code Detail

MEDICARE: PATRICIA PETROSLAVA MARTINOVICH RPH

MEDICARE: PATRICIA PETROSLAVA MARTINOVICH RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPS46911FL

General Provider Information

NPI Number : 1023657962
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA PETROSLAVA MARTINOVICH RPH
Provider Business Mailing Address
First Line : 600 FLAMINGO DR
Second Line :
City : VENICE
State : FL
Zip : 34285-3010
Country : US
Telephone Number : 941-451-8292
Fax Number :
Provider Business Practice Location Address
First Line : 17000 TAMIAMI TRL
Second Line :
City : NORTH PORT
State : FL
Zip : 34287-7281
Country : US
Telephone Number : 941-423-8336
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2019
Last Update Date : 12/23/2019

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Directions to “ PATRICIA PETROSLAVA MARTINOVICH RPH” Practice Location

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