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NPI Code Detail

MEDICARE: MARINA ISHAK

MEDICARE: MARINA ISHAK
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
1183500000XPharmacistPS61276FL

General Provider Information

NPI Number : 1184219172
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARINA ISHAK
Provider Business Mailing Address
First Line : 4904 FORT PECK RD
Second Line :
City : NEW PORT RICHEY
State : FL
Zip : 34655-4318
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 15835 N DALE MABRY HWY
Second Line :
City : TAMPA
State : FL
Zip : 33618-1646
Country : US
Telephone Number : 813-269-4764
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2021
Last Update Date : 03/04/2021

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Directions to “ MARINA ISHAK ” Practice Location

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