MEDICARE: DR. ANDREA MARIE DUSIL 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	PS43640	FL

General Provider Information

NPI Number	:	1619214558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREA MARIE DUSIL PHARMD

Provider Business Mailing Address
First Line	:	3178 GLENRIDGE DR
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34685-1723
Country	:	US
Telephone Number	:	727-743-1704
Fax Number	:

Provider Business Practice Location Address
First Line	:	5324 LITTLE RD
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34655-1294
Country	:	US
Telephone Number	:	727-375-5383
Fax Number	:

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

Provider Enumeration Date	:	01/11/2013
Last Update Date	:	08/10/2023

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