MEDICARE: LONG N PLEASANTS

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	PS62206	FL

General Provider Information

NPI Number	:	1245817139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LONG N PLEASANTS

Provider Business Mailing Address
First Line	:	2 US HIGHWAY 27 S
Second Line	:
City	:	LAKE PLACID
State	:	FL
Zip	:	33852-9453
Country	:	US
Telephone Number	:	863-465-1178
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 US HIGHWAY 27 S
Second Line	:
City	:	LAKE PLACID
State	:	FL
Zip	:	33852-9453
Country	:	US
Telephone Number	:	863-465-1178
Fax Number	:

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

Provider Enumeration Date	:	03/26/2021
Last Update Date	:	03/26/2021

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Directions to “ LONG N PLEASANTS ” Practice Location

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