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NPI Code Detail

MEDICARE: JOSE D BORREGO RPH

MEDICARE: JOSE D BORREGO RPH
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
1183500000XPharmacistPS31509FL

General Provider Information

NPI Number : 1760729768
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSE D BORREGO RPH
Provider Business Mailing Address
First Line : 3825 E BAY DR
Second Line :
City : LARGO
State : FL
Zip : 33771-1936
Country : US
Telephone Number : 727-538-8718
Fax Number : 727-538-8729
Provider Business Practice Location Address
First Line : 3825 E BAY DR
Second Line :
City : LARGO
State : FL
Zip : 33771-1936
Country : US
Telephone Number : 727-538-8718
Fax Number : 727-538-8729
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2013
Last Update Date : 01/10/2013

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Directions to “ JOSE D BORREGO RPH” Practice Location

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