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NPI Code Detail

MEDICARE: CRYSTAL ASHLEY FUOCO PHARM.D

MEDICARE: CRYSTAL ASHLEY FUOCO PHARM.D
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
1183500000XPharmacistPS54880FL

General Provider Information

NPI Number : 1437509882
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRYSTAL ASHLEY FUOCO PHARM.D
Provider Business Mailing Address
First Line : 4402 CURRY FORD RD
Second Line :
City : ORLANDO
State : FL
Zip : 32812-2709
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4402 CURRY FORD RD
Second Line :
City : ORLANDO
State : FL
Zip : 32812-2709
Country : US
Telephone Number : 407-282-8128
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2016
Last Update Date : 06/16/2016

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