MEDICARE: INGRID L FISHER 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
1	183500000X	Pharmacist	38797	FL

General Provider Information

NPI Number	:	1518205830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	INGRID L FISHER PHARMD

Provider Business Mailing Address
First Line	:	200 37TH AVE N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33704-1416
Country	:	US
Telephone Number	:	727-895-7767
Fax Number	:	727-895-7731

Provider Business Practice Location Address
First Line	:	200 37TH AVE N
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33704-1416
Country	:	US
Telephone Number	:	727-895-7767
Fax Number	:	727-895-7731

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

Provider Enumeration Date	:	01/21/2013
Last Update Date	:	01/21/2013

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