MEDICARE: DR. RUTHAN ROBBIRDS WHITE 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
1	183500000X	Pharmacist	PS38732	FL

General Provider Information

NPI Number	:	1649263732
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RUTHAN ROBBIRDS WHITE PHARM.D.

Provider Business Mailing Address
First Line	:	1952 LAZY OAKS LOOP
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34771-8854
Country	:	US
Telephone Number	:	352-359-5437
Fax Number	:	407-303-4519

Provider Business Practice Location Address
First Line	:	400 CELEBRATION PL
Second Line	:
City	:	CELEBRATION
State	:	FL
Zip	:	34747-4970
Country	:	US
Telephone Number	:	407-303-4061
Fax Number	:	407-303-4519

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

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	07/08/2007

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