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NPI Code Detail

MEDICARE: MERCY J NINAN PHARM.D

MEDICARE: MERCY J NINAN 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
11835C0207XCompounded Sterile Preparations PharmacistPU5995FL

General Provider Information

NPI Number : 1588528046
Entity Type Code : Individual
Provider Name (Legal Business Name) : MERCY J NINAN PHARM.D
Provider Business Mailing Address
First Line : 2819 MYSTIC OAKS DR
Second Line :
City : PLANT CITY
State : FL
Zip : 33563-9004
Country : US
Telephone Number : 813-757-1274
Fax Number :
Provider Business Practice Location Address
First Line : 3202 N PARK RD
Second Line :
City : PLANT CITY
State : FL
Zip : 33563-2026
Country : US
Telephone Number : 813-757-1274
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2025
Last Update Date : 12/10/2025

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Directions to “ MERCY J NINAN PHARM.D” Practice Location

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