MEDICARE: DAVID FULTON

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	PS57911	FL

General Provider Information

NPI Number	:	1275138232
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID FULTON

Provider Business Mailing Address
First Line	:	15843 E HIGHWAY 40
Second Line	:
City	:	SILVER SPRINGS
State	:	FL
Zip	:	34488-4149
Country	:	US
Telephone Number	:	352-625-6300
Fax Number	:

Provider Business Practice Location Address
First Line	:	15843 E HIGHWAY 40
Second Line	:
City	:	SILVER SPRINGS
State	:	FL
Zip	:	34488-4149
Country	:	US
Telephone Number	:	352-625-6300
Fax Number	:

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

Provider Enumeration Date	:	11/30/2020
Last Update Date	:	11/30/2020

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Directions to “ DAVID FULTON ” Practice Location

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