MEDICARE: DANA HAGOOD 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
1	183500000X	Pharmacist	PS37189	FL

General Provider Information

NPI Number	:	1508433046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANA HAGOOD RPH.

Provider Business Mailing Address
First Line	:	2912 OCEAN DR
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32963-1949
Country	:	US
Telephone Number	:	772-231-6931
Fax Number	:	772-231-0731

Provider Business Practice Location Address
First Line	:	2912 OCEAN DR
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32963-1949
Country	:	US
Telephone Number	:	772-231-6931
Fax Number	:	772-231-0731

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

Provider Enumeration Date	:	06/04/2021
Last Update Date	:	06/04/2021

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Directions to “ DANA HAGOOD RPH.” Practice Location

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