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NPI Code Detail

MEDICARE: TRAVIS OGWYNN PHARMD

MEDICARE: TRAVIS OGWYNN PHARMD
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
1183500000XPharmacistPS38851FL

General Provider Information

NPI Number : 1326329863
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRAVIS OGWYNN PHARMD
Provider Business Mailing Address
First Line : 15180 TAMIAMI TRL
Second Line :
City : NORTH PORT
State : FL
Zip : 34287-2742
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 15180 TAMIAMI TRL
Second Line :
City : NORTH PORT
State : FL
Zip : 34287-2742
Country : US
Telephone Number : 941-423-6100
Fax Number : 941-423-6700
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2011
Last Update Date : 08/29/2011

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Directions to “ TRAVIS OGWYNN PHARMD” Practice Location

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