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NPI Code Detail

MEDICARE: GINA MISHEL CARRALERO PHARM D

MEDICARE: GINA MISHEL CARRALERO PHARM D
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
1183500000XPharmacistPS36833FL

General Provider Information

NPI Number : 1134409758
Entity Type Code : Individual
Provider Name (Legal Business Name) : GINA MISHEL CARRALERO PHARM D
Provider Business Mailing Address
First Line : 6382 GREEN MYRTLE DR
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32258-3142
Country : US
Telephone Number : 904-880-0222
Fax Number :
Provider Business Practice Location Address
First Line : 3604 BLANDING BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32210-5241
Country : US
Telephone Number : 904-778-8821
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2011
Last Update Date : 08/26/2011

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