MEDICARE: DR. VIRGINIA DENISE CLEAVER PHARMD, RPH, CPH

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	5302033259	MI
2	183500000X	Pharmacist	PS33402	FL
3	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	PU7750	FL
4	1835P2201X	Ambulatory Care Pharmacist	PU7750	FL
5	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	PS33402	FL

General Provider Information

NPI Number	:	1528425220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VIRGINIA DENISE CLEAVER PHARMD, RPH, CPH

Provider Business Mailing Address
First Line	:	6709 RIDGE RD STE 306
Second Line	:
City	:	PORT RICHEY
State	:	FL
Zip	:	34668-6867
Country	:	US
Telephone Number	:	727-203-3202
Fax Number	:	855-898-8002

Provider Business Practice Location Address
First Line	:	6709 RIDGE RD STE 306
Second Line	:
City	:	PORT RICHEY
State	:	FL
Zip	:	34668-6867
Country	:	US
Telephone Number	:	727-203-3202
Fax Number	:	855-898-8002

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

Provider Enumeration Date	:	01/26/2016
Last Update Date	:	01/17/2024

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