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NPI Code Detail

MEDICARE: ALWYN KENRICK MARS RPH

MEDICARE: ALWYN KENRICK MARS 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
1183500000XPharmacistPS38252FL

General Provider Information

NPI Number : 1306126024
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALWYN KENRICK MARS RPH
Provider Business Mailing Address
First Line : 3950 N DEAN RD
Second Line :
City : ORLANDO
State : FL
Zip : 32817-5144
Country : US
Telephone Number : 407-681-6366
Fax Number : 407-681-6359
Provider Business Practice Location Address
First Line : 3950 N DEAN RD
Second Line :
City : ORLANDO
State : FL
Zip : 32817-5144
Country : US
Telephone Number : 407-681-6366
Fax Number : 407-681-6359
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2011
Last Update Date : 08/25/2011

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Directions to “ ALWYN KENRICK MARS RPH” Practice Location

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