MEDICARE: HEATHER FERNANDEZ SMITH PHARMACIST

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
1	183500000X	Pharmacist	PS56964	FL

General Provider Information

NPI Number	:	1083131254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER FERNANDEZ SMITH PHARMACIST

Provider Business Mailing Address
First Line	:	5014 WHITEWAY DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33617-3539
Country	:	US
Telephone Number	:	813-480-9313
Fax Number	:

Provider Business Practice Location Address
First Line	:	5014 WHITEWAY DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33617-3539
Country	:	US
Telephone Number	:	813-480-9313
Fax Number	:	813-480-9313

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2017
Last Update Date	:	08/28/2017

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Directions to “ HEATHER FERNANDEZ SMITH PHARMACIST” Practice Location

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