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NPI Code Detail

MEDICARE: MRS. ZIRNITA J MALLORY RPH.

MEDICARE: MRS. ZIRNITA J MALLORY 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
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistPS31655FL

General Provider Information

NPI Number : 1093046757
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ZIRNITA J MALLORY RPH.
Provider Business Mailing Address
First Line : 220 GRAND REGENCY BLVD
Second Line :
City : BRANDON
State : FL
Zip : 33510-3935
Country : US
Telephone Number : 813-827-9310
Fax Number :
Provider Business Practice Location Address
First Line : 220 GRAND REGENCY BLVD
Second Line :
City : BRANDON
State : FL
Zip : 33510-3935
Country : US
Telephone Number : 813-827-9310
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2010
Last Update Date : 01/20/2010

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